Increased risk of cancer in chronic dialysis patients: A population-based cohort study in Taiwan

Hsuen Fu Lin, Yi Hwei Li, Chih Hsien Wang, Chu Lin Chou, De Jhen Kuo, Te Chao Fang

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Abstract

Background. An increased incidence of cancer in chronic dialysis patients has not been confirmed in the Chinese population. The aim of this population-based study was to examine the risk of various types of cancers in chronic dialysis patients in Taiwan. Methods. Data of 92348 chronic dialysis patients extracted from the National Health Institutes Research Database during 1997-2008 were analyzed. Patients newly diagnosed with end-stage renal disease, free of cancer and receiving dialysis for >3 months were eligible for inclusion in the study. Results. After a mean follow-up of 4.4 years, a new cancer was diagnosed in 4328 chronic dialysis patients. The standardized incidence ratio (SIR) of chronic dialysis patients was 1.4 [95% confidence interval (CI): 1.3-1.4] and annual incidence of cancer was 1.1%. A trend of an increased SIR of cancer was observed in young patients and within the first year of dialysis. Bladder cancer carried the highest SIR (SIR: 8.2, 95% CI: 6.7-9.9) and had the highest frequency (21.2%). Importantly, the frequency (15.3%) of liver cancer was the second highest and the SIR (SIR: 1.4, 95% CI: 1.2-1.5) of liver cancer in chronic dialysis patients was higher than that of their healthy counterparts. Unexpectedly, chronic dialysis patients had a significantly reduced risk of developing lung cancer.Conclusion. Increased risk of cancer in chronic dialysis patients is confirmed in the Taiwanese population and it is necessary to develop different strategies for cancer screening in chronic dialysis patients among different ethnicities.

Original languageEnglish
Pages (from-to)1585-1590
Number of pages6
JournalNephrology Dialysis Transplantation
Volume27
Issue number4
DOIs
Publication statusPublished - Apr 2012

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Taiwan
Dialysis
Cohort Studies
Population
Neoplasms
Incidence
Confidence Intervals
Liver Neoplasms
National Institutes of Health (U.S.)
Early Detection of Cancer
Urinary Bladder Neoplasms
Chronic Kidney Failure
Lung Neoplasms
Databases

Keywords

  • cancer risk
  • chronic dialysis
  • population-based study

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Increased risk of cancer in chronic dialysis patients : A population-based cohort study in Taiwan. / Lin, Hsuen Fu; Li, Yi Hwei; Wang, Chih Hsien; Chou, Chu Lin; Kuo, De Jhen; Fang, Te Chao.

In: Nephrology Dialysis Transplantation, Vol. 27, No. 4, 04.2012, p. 1585-1590.

Research output: Contribution to journalArticle

Lin, Hsuen Fu ; Li, Yi Hwei ; Wang, Chih Hsien ; Chou, Chu Lin ; Kuo, De Jhen ; Fang, Te Chao. / Increased risk of cancer in chronic dialysis patients : A population-based cohort study in Taiwan. In: Nephrology Dialysis Transplantation. 2012 ; Vol. 27, No. 4. pp. 1585-1590.
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abstract = "Background. An increased incidence of cancer in chronic dialysis patients has not been confirmed in the Chinese population. The aim of this population-based study was to examine the risk of various types of cancers in chronic dialysis patients in Taiwan. Methods. Data of 92348 chronic dialysis patients extracted from the National Health Institutes Research Database during 1997-2008 were analyzed. Patients newly diagnosed with end-stage renal disease, free of cancer and receiving dialysis for >3 months were eligible for inclusion in the study. Results. After a mean follow-up of 4.4 years, a new cancer was diagnosed in 4328 chronic dialysis patients. The standardized incidence ratio (SIR) of chronic dialysis patients was 1.4 [95{\%} confidence interval (CI): 1.3-1.4] and annual incidence of cancer was 1.1{\%}. A trend of an increased SIR of cancer was observed in young patients and within the first year of dialysis. Bladder cancer carried the highest SIR (SIR: 8.2, 95{\%} CI: 6.7-9.9) and had the highest frequency (21.2{\%}). Importantly, the frequency (15.3{\%}) of liver cancer was the second highest and the SIR (SIR: 1.4, 95{\%} CI: 1.2-1.5) of liver cancer in chronic dialysis patients was higher than that of their healthy counterparts. Unexpectedly, chronic dialysis patients had a significantly reduced risk of developing lung cancer.Conclusion. Increased risk of cancer in chronic dialysis patients is confirmed in the Taiwanese population and it is necessary to develop different strategies for cancer screening in chronic dialysis patients among different ethnicities.",
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N2 - Background. An increased incidence of cancer in chronic dialysis patients has not been confirmed in the Chinese population. The aim of this population-based study was to examine the risk of various types of cancers in chronic dialysis patients in Taiwan. Methods. Data of 92348 chronic dialysis patients extracted from the National Health Institutes Research Database during 1997-2008 were analyzed. Patients newly diagnosed with end-stage renal disease, free of cancer and receiving dialysis for >3 months were eligible for inclusion in the study. Results. After a mean follow-up of 4.4 years, a new cancer was diagnosed in 4328 chronic dialysis patients. The standardized incidence ratio (SIR) of chronic dialysis patients was 1.4 [95% confidence interval (CI): 1.3-1.4] and annual incidence of cancer was 1.1%. A trend of an increased SIR of cancer was observed in young patients and within the first year of dialysis. Bladder cancer carried the highest SIR (SIR: 8.2, 95% CI: 6.7-9.9) and had the highest frequency (21.2%). Importantly, the frequency (15.3%) of liver cancer was the second highest and the SIR (SIR: 1.4, 95% CI: 1.2-1.5) of liver cancer in chronic dialysis patients was higher than that of their healthy counterparts. Unexpectedly, chronic dialysis patients had a significantly reduced risk of developing lung cancer.Conclusion. Increased risk of cancer in chronic dialysis patients is confirmed in the Taiwanese population and it is necessary to develop different strategies for cancer screening in chronic dialysis patients among different ethnicities.

AB - Background. An increased incidence of cancer in chronic dialysis patients has not been confirmed in the Chinese population. The aim of this population-based study was to examine the risk of various types of cancers in chronic dialysis patients in Taiwan. Methods. Data of 92348 chronic dialysis patients extracted from the National Health Institutes Research Database during 1997-2008 were analyzed. Patients newly diagnosed with end-stage renal disease, free of cancer and receiving dialysis for >3 months were eligible for inclusion in the study. Results. After a mean follow-up of 4.4 years, a new cancer was diagnosed in 4328 chronic dialysis patients. The standardized incidence ratio (SIR) of chronic dialysis patients was 1.4 [95% confidence interval (CI): 1.3-1.4] and annual incidence of cancer was 1.1%. A trend of an increased SIR of cancer was observed in young patients and within the first year of dialysis. Bladder cancer carried the highest SIR (SIR: 8.2, 95% CI: 6.7-9.9) and had the highest frequency (21.2%). Importantly, the frequency (15.3%) of liver cancer was the second highest and the SIR (SIR: 1.4, 95% CI: 1.2-1.5) of liver cancer in chronic dialysis patients was higher than that of their healthy counterparts. Unexpectedly, chronic dialysis patients had a significantly reduced risk of developing lung cancer.Conclusion. Increased risk of cancer in chronic dialysis patients is confirmed in the Taiwanese population and it is necessary to develop different strategies for cancer screening in chronic dialysis patients among different ethnicities.

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