Cancer Risk in Cystic Fibrosis: A 20-Year Nationwide Study From the United States

被引:223
作者
Maisonneuve, Patrick [1 ]
Marshall, Bruce C. [2 ]
Knapp, Emily A. [2 ]
Lowenfels, Albert B. [3 ]
机构
[1] European Inst Oncol, Div Epidemiol & Biostat, I-20141 Milan, Italy
[2] Cyst Fibrosis Fdn, Bethesda, MD USA
[3] New York Med Coll, Dept Surg & Community & Prevent Med, Valhalla, NY 10595 USA
来源
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE | 2013年 / 105卷 / 02期
关键词
TRANSPLANT RECIPIENTS; EPIDEMIOLOGY; MALIGNANCY; GENE;
D O I
10.1093/jnci/djs481
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background Many patients with cystic fibrosis (CF) now reach adulthood, at which time the risk of cancer is increased. The aim of this study was to determine cancer risks in nontransplanted and transplanted CF patients. Methods From 1990 to 2009, we followed 41,188 patients who received care at one of the 250 CF care center programs in the United States and compared the observed number of cancers in nontransplanted and transplanted patients with that expected in the general US population. Results In 344,114 patient-years of observation of nontransplanted patients, the overall cancer risk was similar to the background risk (standardized incidence ratio [SIR] = 1.1, 95% confidence interval [CI] = 1.0 to 1.3). However, we observed an elevated risk of digestive tract cancer (SIR = 3.5, 95% CI = 2.6 to 4.7) involving the esophago-gastric junction, biliary tract, small bowel, and colon. There was also an increased risk of testicular cancer (SIR = 1.7, 95% CI = 1.02 to 2.7) and lymphoid leukemia (SIR = 2.0, 95% CI = 1.2 to 3.1) and a decreased risk of malignant melanoma (SIR = 0.4, 95% CI = 0.2 to 0.9). In 8235 patient-years of observation of transplanted patients, 26 tumors were observed compared with 9.6 expected (SIR = 2.7, 95% CI = 1.8 to 3.9). The increased risk was particularly high for digestive tract cancers (SIR = 17.3, 95% CI = 10.7 to 26.5), with most cases arising in the bowel. Conclusions The overall burden of cancer in CF patients remains low; however they have an increased risk of digestive tract cancer, particularly following transplantation. They also have increased risk of lymphoid leukemia and testicular cancer, and decreased risk of melanoma. J Natl Cancer Inst 2013;105:122-129
引用
收藏
页码:122 / 129
页数:8
相关论文
共 24 条
[1]  
ABDULKARIM FW, 1982, GASTROENTEROLOGY, V82, P758
[2]  
[Anonymous], SURV EP END RE UNPUB
[3]  
Brodzicki Jacek, 2002, Med Sci Monit, V8, pCR529
[4]  
Cystic Fibrosis Foundation, 2011, CYST FIBR FDN PAT RE
[5]   Spectrum of Cancer Risk Among US Solid Organ Transplant Recipients [J].
Engels, Eric A. ;
Pfeiffer, Ruth M. ;
Fraumeni, Joseph F., Jr. ;
Kasiske, Bertram L. ;
Israni, Ajay K. ;
Snyder, Jon J. ;
Wolfe, Robert A. ;
Goodrich, Nathan P. ;
Bayakly, A. Rana ;
Clarke, Christina A. ;
Copeland, Glenn ;
Finch, Jack L. ;
Fleissner, Mary Lou ;
Goodman, Marc T. ;
Kahn, Amy ;
Koch, Lori ;
Lynch, Charles F. ;
Madeleine, Margaret M. ;
Pawlish, Karen ;
Rao, Chandrika ;
Williams, Melanie A. ;
Castenson, David ;
Curry, Michael ;
Parsons, Ruth ;
Fant, Gregory ;
Lin, Monica .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2011, 306 (17) :1891-1901
[6]   REPRESENTATIVENESS OF THE SURVEILLANCE, EPIDEMIOLOGY, AND END RESULTS PROGRAM DATA - RECENT TRENDS IN CANCER MORTALITY-RATES [J].
FREY, CM ;
MCMILLEN, MM ;
COWAN, CD ;
HORM, JW ;
KESSLER, LG .
JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1992, 84 (11) :872-877
[7]   Risk factors for colorectal neoplasia in inflammatory bowel disease: A nested case-control study from copenhagen county, denmark and olmsted county, minnesota [J].
Jess, Tine ;
Loftus, Edward V., Jr. ;
Velayos, Fernando S. ;
Winther, Karen V. ;
Tremaine, William J. ;
Zinsmeister, Alan R. ;
Harmsen, W. Scott ;
Langholz, Ebbe ;
Binder, Vibeke ;
Munkholm, Pia ;
Sandborn, William J. .
AMERICAN JOURNAL OF GASTROENTEROLOGY, 2007, 102 (04) :829-836
[8]   Cancer risk among patients with cystic fibrosis and their first-degree relatives [J].
Johannesson, Marie ;
Askling, Johan ;
Montgomery, Scott M. ;
Ekbom, Anders ;
Bahmanyar, Shahram .
INTERNATIONAL JOURNAL OF CANCER, 2009, 125 (12) :2953-2956
[9]   Cancer risk in nontransplanted and transplanted cystic fibrosis patients: A 10-year study [J].
Maisonneuve, P ;
FitzSimmons, SC ;
Neglia, JP ;
Campbell, PW ;
Lowenfels, AB .
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2003, 95 (05) :381-387
[10]   Epidemiology of testicular cancer [J].
Manecksha, Rustom P. ;
Fitzpatrick, John M. .
BJU INTERNATIONAL, 2009, 104 (9B) :1329-1333