2005 Abstracts: Colorectal Cancer Among Solid-Organ Transplant Recipients
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Colorectal Cancer Among Solid-Organ Transplant Recipients
Erik Johnson, John Pirsch, University of Wisconsin, Madison, WI; Charles Heise, University of Wisconsin Madison, Madison, WI
The solid-organ transplant database at the University of Wisconsin tracks post-transplant diagnoses at one of the largest transplant centers in the world. Formal data collection for post-transplant colorectal malignancy began on January 1, 1994. We reviewed our experience through 2001 to determine the incidence, age, and stage at presentation for colorectal malignancies in the transplant population.
Methods: All solid-organ transplant recipients were eligible for this retrospective study. The transplant database was cross-referenced using diagnosis codes for all colorectal malignancies to configure a list of eligible patients. Patient data was then reviewed using computer and paper charts. Patients were deemed ineligible for the study if their first transplant occurred before Jan 1, 1993, to ensure at least one year of data collection post transplant or if their cancer was diagnosed less than 12 months after transplantation. Results: A total of 2990 kidney, liver or combined kidney-pancreas transplants occurred between Jan. 1, 1993 through Dec. 31, 2001. We identified a total of 22 cases of colorectal adenocarcinoma in 14 males and 8 females, for an overall incidence of 0.7%. Four of these cases were excluded due to cancer diagnosis within 12 months of transplant leaving a total of 18 cases for review (15 colon, 3 rectum). Three of the liver transplant patients but none of the kidney or kidney/pancreas transplants had inflammatory bowel disease. The median age at diagnosis was 61 years (range 39-71). The average time from first transplant to cancer diagnosis was 51.2 months, with an average post-transplant follow-up of 70.1 months (range 13-131). Of these cancers, 9 were stage I, 1 was stage II, 4 were stage III and 4 were stage IV at the time of diagnosis. By comparison, the National Cancer Institute SEER database reports a colon and rectal cancer incidence of 53.7/100,000 (0.005%) between 1992 and 2001 with a median age at diagnosis of 72.0 years.| Transplant Organ: | Kidney | Kidney/Pancreas | Liver |
| Total cases (1/93-12/01) | 2212 | 210 | 568 |
| Cases of Adenocarcinoma (n=18) | 10 | 0 | 8 |
| Incidence | 0.40% | -- | 1.40% |
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