Cancer risks in people on dialysis and kidney transplant recipients: a Catalan cohort study, 2003-21

Abstract

Background: People with kidney failure have a higher risk of cancer compared with age- and sex-matched individuals in the general population, yet data from southern Europe are limited. This study explores cancer incidence in the kidney failure population in Catalonia. Methods: We identified cancer cases through linkage of the Catalan Kidney Registry with Catalan cancer databases. Standardized incidence ratios (SIRs) were calculated for all-site and site-specific cancers in people on dialysis and kidney transplant recipients. Results: We described the epidemiology of cancer in 21 595 people on dialysis and 8037 kidney transplant recipients in Catalonia (2003-21). Cancer risk was more than two times higher in people on dialysis (SIR 2.11, 95% CI 2.02-2.19) and nearly four times higher in kidney transplant recipients (SIR 3.82, 95% CI 3.65-3.99) compared with the general population. Risks varied by cancer site, with a significantly higher incidence of kidney and thyroid cancers in the dialysis cohort, and skin cancer in the transplant cohort. The highest cancer risks were observed in the youngest, those with glomerular diseases, and those with the longest time since transplantation. Conclusions: People with kidney failure face a high burden of cancer, particularly after kidney transplantation. Understanding the epidemiology of cancer in the kidney failure population is crucial for shaping health policies.