Prostate cancer in kidney transplant recipients – a nationwide register study
Objective To investigate whether post‐transplantation immunosuppression negatively affects prostate cancer outcomes in male kidney transplant recipients. Patients and Methods We used the Swedish Renal Register and the National Prostate Cancer Register to identify all kidney transplantation recipient...
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| Veröffentlicht in: | BJU international 2020-05, Vol.125 (5), p.679-685 |
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| creator | Bratt, Ola Drevin, Linda Prütz, Karl‐Göran Carlsson, Stefan Wennberg, Lars Stattin, Pär |
| description | Objective
To investigate whether post‐transplantation immunosuppression negatively affects prostate cancer outcomes in male kidney transplant recipients.
Patients and Methods
We used the Swedish Renal Register and the National Prostate Cancer Register to identify all kidney transplantation recipients diagnosed with prostate cancer in Sweden 1998–2016. After linking these registers with Prostate Cancer Database Sweden (PCBaSe), a case‐control study was designed to compare time period and risk category‐specific probabilities of a prostate cancer diagnosis amongst kidney transplantation recipients versus the male general population. The registers did not include information about the specific immunosuppression agent used in all transplantation recipients. Data from PCBaSe were used to compare prostate cancer characteristics at diagnosis and survival for patients with prostate cancer with versus without a kidney transplant. Propensity score matching, Cox regression analysis and Fisher's exact test were used and 95% confidence intervals (CIs) calculated.
Results
Almost half of the 133 kidney transplantation recipients were transplanted before the mid‐1990s, when PSA testing became common. The transplant recipients were not more likely than age‐matched control men to be diagnosed with any (odds ratio [OR] 0.84, 95% CI 0.70–0.99) or high‐risk or metastatic prostate cancer (OR 0.84, 95% CI 0.62–1.13). None of the ORs for the different categories of prostate cancer increased with time since transplantation. Cancer characteristics at the time of diagnosis and cancer‐specific survival were similar amongst transplant recipients and the control group of 665 men diagnosed with prostate cancer without a kidney transplant.
Conclusions
This Swedish nationwide, register‐based study gave no indication that immunosuppression after kidney transplantation increases the risk of prostate cancer or adversely affects prostate cancer outcomes. The study suggests that men with untreated low‐grade prostate cancer can be accepted for transplantation. |
| doi_str_mv | 10.1111/bju.15002 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_474169</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2342354765</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5512-f926d8fdcfb47355acde0e505f01108cda6b3f1bc771fd535fc84466a5960e6f3</originalsourceid><addsrcrecordid>eNp9ksluFDEQhlsIRBY48AKoJS5EopOy23ZPH0PYFSkcCOJmub2MPJnpbrxoNDfegTfkSaihZ4KENPjiUvmrv0rlvyieETgneC66RT4nHIA-KI4JE6xiBL493MfQiqPiJMYFACYEf1wc1aTlnLXNcXHzOQwxqWRLrXptQ-n78s6b3m7KFFQfx6XqUxms9qO3fYrlrx8_S1X2KvmhX3tj8W3uY8LKmLLZPCkeObWM9unuPi1u3739cvWhur55__Hq8rrSnBNauZYKM3NGu441NedKGwuWA3dACMy0UaKrHel00xBneM2dnjEcXvFWgBWuPi2qSTeu7Zg7OQa_UmEjB-XlLnWHkZWsYUS0yLcH-TEM5m_RvpAw2jKgMPtvr3keJabmeVtCW0IFIP_qIP_Gf72UQ5jLnCUDJoAg_nLCcY7v2cYkVz5qu8TN2yFHSWtGa84awRF98Q-6GHLocdFI4WaAU7btfzZRGv82BuvuJyAgt4aRaBj5xzDIPt8p5m5lzT25dwgCFxOw9ku7OawkX3-6nSR_A7cUzLg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2396005240</pqid></control><display><type>article</type><title>Prostate cancer in kidney transplant recipients – a nationwide register study</title><source>SWEPUB Freely available online</source><source>Wiley Blackwell Single Titles</source><creator>Bratt, Ola ; Drevin, Linda ; Prütz, Karl‐Göran ; Carlsson, Stefan ; Wennberg, Lars ; Stattin, Pär</creator><creatorcontrib>Bratt, Ola ; Drevin, Linda ; Prütz, Karl‐Göran ; Carlsson, Stefan ; Wennberg, Lars ; Stattin, Pär</creatorcontrib><description>Objective
To investigate whether post‐transplantation immunosuppression negatively affects prostate cancer outcomes in male kidney transplant recipients.
Patients and Methods
We used the Swedish Renal Register and the National Prostate Cancer Register to identify all kidney transplantation recipients diagnosed with prostate cancer in Sweden 1998–2016. After linking these registers with Prostate Cancer Database Sweden (PCBaSe), a case‐control study was designed to compare time period and risk category‐specific probabilities of a prostate cancer diagnosis amongst kidney transplantation recipients versus the male general population. The registers did not include information about the specific immunosuppression agent used in all transplantation recipients. Data from PCBaSe were used to compare prostate cancer characteristics at diagnosis and survival for patients with prostate cancer with versus without a kidney transplant. Propensity score matching, Cox regression analysis and Fisher's exact test were used and 95% confidence intervals (CIs) calculated.
Results
Almost half of the 133 kidney transplantation recipients were transplanted before the mid‐1990s, when PSA testing became common. The transplant recipients were not more likely than age‐matched control men to be diagnosed with any (odds ratio [OR] 0.84, 95% CI 0.70–0.99) or high‐risk or metastatic prostate cancer (OR 0.84, 95% CI 0.62–1.13). None of the ORs for the different categories of prostate cancer increased with time since transplantation. Cancer characteristics at the time of diagnosis and cancer‐specific survival were similar amongst transplant recipients and the control group of 665 men diagnosed with prostate cancer without a kidney transplant.
Conclusions
This Swedish nationwide, register‐based study gave no indication that immunosuppression after kidney transplantation increases the risk of prostate cancer or adversely affects prostate cancer outcomes. The study suggests that men with untreated low‐grade prostate cancer can be accepted for transplantation.</description><identifier>ISSN: 1464-4096</identifier><identifier>ISSN: 1464-410X</identifier><identifier>EISSN: 1464-410X</identifier><identifier>DOI: 10.1111/bju.15002</identifier><identifier>PMID: 31955497</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Clinical Medicine ; Diagnosis ; dialysis duration ; disease ; Health risk assessment ; Immunosuppression ; incidence ; international-society ; isup consensus conference ; Kidney transplantation ; Kidney transplants ; KidneyTransplant ; Klinisk medicin ; Medicin och hälsovetenskap ; men ; Metastases ; outcome ; PCSM ; prevalence ; prognosis ; Prostate cancer ; ProstateCancer ; renal transplantation ; risk ; Survival ; sweden ; Transplants & implants ; Urology & Nephrology</subject><ispartof>BJU international, 2020-05, Vol.125 (5), p.679-685</ispartof><rights>2020 The Authors BJU International Published by John Wiley & Sons Ltd on behalf of BJU International</rights><rights>2020 The Authors BJU International Published by John Wiley & Sons Ltd on behalf of BJU International.</rights><rights>2020. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5512-f926d8fdcfb47355acde0e505f01108cda6b3f1bc771fd535fc84466a5960e6f3</citedby><cites>FETCH-LOGICAL-c5512-f926d8fdcfb47355acde0e505f01108cda6b3f1bc771fd535fc84466a5960e6f3</cites><orcidid>0000-0002-8489-5029 ; 0000-0002-9198-9445 ; 0000-0002-8306-0687</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbju.15002$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbju.15002$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,552,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31955497$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-404601$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://gup.ub.gu.se/publication/291260$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:142940208$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Bratt, Ola</creatorcontrib><creatorcontrib>Drevin, Linda</creatorcontrib><creatorcontrib>Prütz, Karl‐Göran</creatorcontrib><creatorcontrib>Carlsson, Stefan</creatorcontrib><creatorcontrib>Wennberg, Lars</creatorcontrib><creatorcontrib>Stattin, Pär</creatorcontrib><title>Prostate cancer in kidney transplant recipients – a nationwide register study</title><title>BJU international</title><addtitle>BJU Int</addtitle><description>Objective
To investigate whether post‐transplantation immunosuppression negatively affects prostate cancer outcomes in male kidney transplant recipients.
Patients and Methods
We used the Swedish Renal Register and the National Prostate Cancer Register to identify all kidney transplantation recipients diagnosed with prostate cancer in Sweden 1998–2016. After linking these registers with Prostate Cancer Database Sweden (PCBaSe), a case‐control study was designed to compare time period and risk category‐specific probabilities of a prostate cancer diagnosis amongst kidney transplantation recipients versus the male general population. The registers did not include information about the specific immunosuppression agent used in all transplantation recipients. Data from PCBaSe were used to compare prostate cancer characteristics at diagnosis and survival for patients with prostate cancer with versus without a kidney transplant. Propensity score matching, Cox regression analysis and Fisher's exact test were used and 95% confidence intervals (CIs) calculated.
Results
Almost half of the 133 kidney transplantation recipients were transplanted before the mid‐1990s, when PSA testing became common. The transplant recipients were not more likely than age‐matched control men to be diagnosed with any (odds ratio [OR] 0.84, 95% CI 0.70–0.99) or high‐risk or metastatic prostate cancer (OR 0.84, 95% CI 0.62–1.13). None of the ORs for the different categories of prostate cancer increased with time since transplantation. Cancer characteristics at the time of diagnosis and cancer‐specific survival were similar amongst transplant recipients and the control group of 665 men diagnosed with prostate cancer without a kidney transplant.
Conclusions
This Swedish nationwide, register‐based study gave no indication that immunosuppression after kidney transplantation increases the risk of prostate cancer or adversely affects prostate cancer outcomes. The study suggests that men with untreated low‐grade prostate cancer can be accepted for transplantation.</description><subject>Clinical Medicine</subject><subject>Diagnosis</subject><subject>dialysis duration</subject><subject>disease</subject><subject>Health risk assessment</subject><subject>Immunosuppression</subject><subject>incidence</subject><subject>international-society</subject><subject>isup consensus conference</subject><subject>Kidney transplantation</subject><subject>Kidney transplants</subject><subject>KidneyTransplant</subject><subject>Klinisk medicin</subject><subject>Medicin och hälsovetenskap</subject><subject>men</subject><subject>Metastases</subject><subject>outcome</subject><subject>PCSM</subject><subject>prevalence</subject><subject>prognosis</subject><subject>Prostate cancer</subject><subject>ProstateCancer</subject><subject>renal transplantation</subject><subject>risk</subject><subject>Survival</subject><subject>sweden</subject><subject>Transplants & implants</subject><subject>Urology & Nephrology</subject><issn>1464-4096</issn><issn>1464-410X</issn><issn>1464-410X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>D8T</sourceid><recordid>eNp9ksluFDEQhlsIRBY48AKoJS5EopOy23ZPH0PYFSkcCOJmub2MPJnpbrxoNDfegTfkSaihZ4KENPjiUvmrv0rlvyieETgneC66RT4nHIA-KI4JE6xiBL493MfQiqPiJMYFACYEf1wc1aTlnLXNcXHzOQwxqWRLrXptQ-n78s6b3m7KFFQfx6XqUxms9qO3fYrlrx8_S1X2KvmhX3tj8W3uY8LKmLLZPCkeObWM9unuPi1u3739cvWhur55__Hq8rrSnBNauZYKM3NGu441NedKGwuWA3dACMy0UaKrHel00xBneM2dnjEcXvFWgBWuPi2qSTeu7Zg7OQa_UmEjB-XlLnWHkZWsYUS0yLcH-TEM5m_RvpAw2jKgMPtvr3keJabmeVtCW0IFIP_qIP_Gf72UQ5jLnCUDJoAg_nLCcY7v2cYkVz5qu8TN2yFHSWtGa84awRF98Q-6GHLocdFI4WaAU7btfzZRGv82BuvuJyAgt4aRaBj5xzDIPt8p5m5lzT25dwgCFxOw9ku7OawkX3-6nSR_A7cUzLg</recordid><startdate>202005</startdate><enddate>202005</enddate><creator>Bratt, Ola</creator><creator>Drevin, Linda</creator><creator>Prütz, Karl‐Göran</creator><creator>Carlsson, Stefan</creator><creator>Wennberg, Lars</creator><creator>Stattin, Pär</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7X8</scope><scope>ACNBI</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>DF2</scope><scope>ZZAVC</scope><scope>F1U</scope><orcidid>https://orcid.org/0000-0002-8489-5029</orcidid><orcidid>https://orcid.org/0000-0002-9198-9445</orcidid><orcidid>https://orcid.org/0000-0002-8306-0687</orcidid></search><sort><creationdate>202005</creationdate><title>Prostate cancer in kidney transplant recipients – a nationwide register study</title><author>Bratt, Ola ; Drevin, Linda ; Prütz, Karl‐Göran ; Carlsson, Stefan ; Wennberg, Lars ; Stattin, Pär</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5512-f926d8fdcfb47355acde0e505f01108cda6b3f1bc771fd535fc84466a5960e6f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Clinical Medicine</topic><topic>Diagnosis</topic><topic>dialysis duration</topic><topic>disease</topic><topic>Health risk assessment</topic><topic>Immunosuppression</topic><topic>incidence</topic><topic>international-society</topic><topic>isup consensus conference</topic><topic>Kidney transplantation</topic><topic>Kidney transplants</topic><topic>KidneyTransplant</topic><topic>Klinisk medicin</topic><topic>Medicin och hälsovetenskap</topic><topic>men</topic><topic>Metastases</topic><topic>outcome</topic><topic>PCSM</topic><topic>prevalence</topic><topic>prognosis</topic><topic>Prostate cancer</topic><topic>ProstateCancer</topic><topic>renal transplantation</topic><topic>risk</topic><topic>Survival</topic><topic>sweden</topic><topic>Transplants & implants</topic><topic>Urology & Nephrology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bratt, Ola</creatorcontrib><creatorcontrib>Drevin, Linda</creatorcontrib><creatorcontrib>Prütz, Karl‐Göran</creatorcontrib><creatorcontrib>Carlsson, Stefan</creatorcontrib><creatorcontrib>Wennberg, Lars</creatorcontrib><creatorcontrib>Stattin, Pär</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Online Library (Open Access Collection)</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><collection>SWEPUB Uppsala universitet full text</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SWEPUB Uppsala universitet</collection><collection>SwePub Articles full text</collection><collection>SWEPUB Göteborgs universitet</collection><jtitle>BJU international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bratt, Ola</au><au>Drevin, Linda</au><au>Prütz, Karl‐Göran</au><au>Carlsson, Stefan</au><au>Wennberg, Lars</au><au>Stattin, Pär</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prostate cancer in kidney transplant recipients – a nationwide register study</atitle><jtitle>BJU international</jtitle><addtitle>BJU Int</addtitle><date>2020-05</date><risdate>2020</risdate><volume>125</volume><issue>5</issue><spage>679</spage><epage>685</epage><pages>679-685</pages><issn>1464-4096</issn><issn>1464-410X</issn><eissn>1464-410X</eissn><abstract>Objective
To investigate whether post‐transplantation immunosuppression negatively affects prostate cancer outcomes in male kidney transplant recipients.
Patients and Methods
We used the Swedish Renal Register and the National Prostate Cancer Register to identify all kidney transplantation recipients diagnosed with prostate cancer in Sweden 1998–2016. After linking these registers with Prostate Cancer Database Sweden (PCBaSe), a case‐control study was designed to compare time period and risk category‐specific probabilities of a prostate cancer diagnosis amongst kidney transplantation recipients versus the male general population. The registers did not include information about the specific immunosuppression agent used in all transplantation recipients. Data from PCBaSe were used to compare prostate cancer characteristics at diagnosis and survival for patients with prostate cancer with versus without a kidney transplant. Propensity score matching, Cox regression analysis and Fisher's exact test were used and 95% confidence intervals (CIs) calculated.
Results
Almost half of the 133 kidney transplantation recipients were transplanted before the mid‐1990s, when PSA testing became common. The transplant recipients were not more likely than age‐matched control men to be diagnosed with any (odds ratio [OR] 0.84, 95% CI 0.70–0.99) or high‐risk or metastatic prostate cancer (OR 0.84, 95% CI 0.62–1.13). None of the ORs for the different categories of prostate cancer increased with time since transplantation. Cancer characteristics at the time of diagnosis and cancer‐specific survival were similar amongst transplant recipients and the control group of 665 men diagnosed with prostate cancer without a kidney transplant.
Conclusions
This Swedish nationwide, register‐based study gave no indication that immunosuppression after kidney transplantation increases the risk of prostate cancer or adversely affects prostate cancer outcomes. The study suggests that men with untreated low‐grade prostate cancer can be accepted for transplantation.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31955497</pmid><doi>10.1111/bju.15002</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-8489-5029</orcidid><orcidid>https://orcid.org/0000-0002-9198-9445</orcidid><orcidid>https://orcid.org/0000-0002-8306-0687</orcidid><oa>free_for_read</oa></addata></record> |
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| source | SWEPUB Freely available online; Wiley Blackwell Single Titles |
| subjects | Clinical Medicine Diagnosis dialysis duration disease Health risk assessment Immunosuppression incidence international-society isup consensus conference Kidney transplantation Kidney transplants KidneyTransplant Klinisk medicin Medicin och hälsovetenskap men Metastases outcome PCSM prevalence prognosis Prostate cancer ProstateCancer renal transplantation risk Survival sweden Transplants & implants Urology & Nephrology |
| title | Prostate cancer in kidney transplant recipients – a nationwide register study |
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