Solid Organ Transplant and Cancer Risk
Am I at risk for cancer after my solid organ transplant?
People who have had solid organ transplants (lung, heart, liver, kidney) have a higher risk of developing cancer. This is most often due to medications used to suppress the immune system. These medications, called “immunosuppressive” medications, are used to prevent rejection of the transplanted organ, as well as infection with viruses known to cause cancer (HPV, Epstein Barr, H. Pylori). The risk of different cancers varies depending on the organ transplanted, which immunosuppressive medications are used, their doses, and other risk factors you may also have.
The cancers that occur at higher rates in people who receive transplants include:
- Non-melanoma skin cancers (squamous cell and basal cell).
- Non-Hodgkin lymphoma or Post-transplant lymphoproliferative disorders (PTLD).
- Kaposi sarcoma.
- Cancers of the anogenital area (anus, vulva, penis).
- Head & neck cancers (lip, oral, tonsil are most common).
- Kidney cancer.
- Lung cancer.
- Hodgkin lymphoma.
- Thyroid cancer.
- Stomach cancer.
- Liver cancer.
- Colorectal cancer.
How can I reduce my risk of cancer?
The increased risk of cancer has been a known complication of transplant for many years. Studies have found that certain immunosuppressive medications can increase this risk more than others. In addition, higher doses of immunosuppressive medications can increase the risk. Transplant teams consider these findings, balancing the need to prevent organ rejection with cancer risk.
Many of these cancers have other risk factors that you can work toward for healthy lifestyle choices, including:
- Practicing sun safety – or sun avoidance.
- Not using tobacco products.
- Limiting alcohol intake.
- Reducing the risk of HPV through safe sex practices.
Due to the increased risk of cancer, it is important that you undergo cancer screenings recommended for your age and health history. It is important to point out that these screenings are not the same as for the general public. Transplant experts recommend additional screenings based on the organ transplanted and your own risk factors. Talk with your transplant team about what cancer screening tests you should have and how often.
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Collett, D., Mumford, L., Banner, N. R., Neuberger, J., & Watson, C. (2010). Comparison of the incidence of malignancy in recipients of different types of organ: a UK Registry audit. American Journal of Transplantation, 10(8), 1889-1896.
Engels, E. A., Pfeiffer, R. M., Fraumeni, J. F., Kasiske, B. L., Israni, A. K., Snyder, J. J., ... & Copeland, G. (2011). Spectrum of cancer risk among US solid organ transplant recipients. Jama, 306(17), 1891-1901.
Fernberg, P., Edgren, G., Adami, J., Ingvar, Å., Bellocco, R., Tufveson, G., ... & Lindelöf, B. (2011). Time trends in risk and risk determinants of non‐Hodgkin lymphoma in solid organ transplant recipients. American journal of transplantation, 11(11), 2472-2482.
Neuburg, M. (2007). Transplant-associated skin cancer: role of reducing immunosuppression. Journal of the National Comprehensive Cancer Network, 5(5), 541-549.