Increased incidence of gastric cancer in renal transplant recipients

J Clin Gastroenterol. 2012 Nov-Dec;46(10):e87-91. doi: 10.1097/MCG.0b013e31825c0b3a.

Abstract

Objective: The risk of malignancy after transplantation is regarded to be higher than in the general population. The aim of this study was to evaluate the frequency of gastric cancer in renal transplant recipients.

Methods: A total of 820 renal transplantation recipients were invited for gastric cancer screening. Frequencies of gastric cancer in this cohort and in 10,080 asymptomatic subjects were compared. Cancer specimens were examined for Epstein-Barr virus by in situ hybridization.

Results: A total of 509 recipients (mean age, 48.1 ± 10.7 y; men, 56.8%) participated. Fifteen (2.9%) and 10 (0.1%) cases of adenocarcinoma were identified among recipients and controls, respectively (P<0.001; odds ratio, 30.58). Early gastric cancer was detected in 9 of the 15 recipients, and 4 of the 9 were treated by endoscopic resection. Recipient age was found to be a significant factor of gastric cancer development. In cancer tissues, Epstein-Barr virus was detected in 5 (33.3%) renal recipients and in 1 (10%) of the controls, respectively.

Conclusions: The frequency of gastric cancer was found to be higher in renal recipients than in controls. Gastric cancer screening should be considered after transplantation, because it would provide cure by minimally invasive treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / epidemiology*
  • Adenocarcinoma / surgery
  • Adenocarcinoma / virology
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Confidence Intervals
  • Epstein-Barr Virus Infections / epidemiology
  • Female
  • Gastroscopy
  • Helicobacter Infections / epidemiology
  • Helicobacter pylori
  • Herpesvirus 4, Human
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Kidney Transplantation / adverse effects
  • Kidney Transplantation / immunology*
  • Male
  • Middle Aged
  • Odds Ratio
  • Population Surveillance
  • Republic of Korea / epidemiology
  • Stomach Neoplasms / epidemiology*
  • Stomach Neoplasms / surgery
  • Stomach Neoplasms / virology
  • Time Factors
  • Young Adult

Substances

  • Immunosuppressive Agents