Increased Incidence of Colorectal Malignancies in Renal Transplant Recipients: A Case Control Study

Abstract

This study was to evaluate the frequency of colorectal neoplasia in renal transplant recipients and to investigate the association with Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infection. We compared the frequency of colorectal neoplasia among renal transplant recipients with that of the healthy subjects. Specimens of colorectal neoplasia were examined for EBV and CMV using in situ hybridization and immunohistochemistry, respectively. Of 796 renal transplantation cohorts, 315 were enrolled. The frequency of colorectal neoplasia among the patients was 22.9%. Compared with the healthy subjects, the odds ratio (OR) for advanced adenoma was 3.32 (95% CI, 1.81-6.10). The frequency of cancer among the patients was 1.9% (OR, 12.0; 95% CI, 1.45-99.7). A long interval between transplantation and colonoscopy was a significant factor in the development of advanced colorectal neoplasia. EBV positivity was detected in 30.6% of colorectal neoplasia specimens from renal transplant recipients, which was higher than that for the controls (p = 0.002). CMV was not detected in any lesions of patients or controls. In conclusion, renal transplant recipients have a significantly increased risk of advanced colorectal neoplasia. EBV was more frequently found in specimens of advanced colorectal neoplasm obtained from the renal transplant recipients.

Role of Oncogenic Pathways and KRAS/BRAF Mutations in the Behavior of Colon Adenocarcinoma in Renal Transplant Patients

“…In our study, we compared KTR and CP with the same type of CRC. In agreement with previous reports (11,12), we found that kidney function was higher and there was a trend for mean age different at time of neoplasia and long-term immunosuppression for CRC in KTR. Our results did not reach significance probably because of the sample size, as Spier et al reported (11).…”

“…Although we found fewer adenomas than other lesions in KTR (16.7%), the percentage was equivalent to that of another group with a higher prevalence (20%) (12). Adenoma is the premalignant lesion with the greatest impact on outcome in patients with CRC.…”

“…Only few articles have described the relative risk between two populations (11,12). In our study, we compared KTR and CP with the same type of CRC.…”

“…siveness of cancer and poorer patient prognosis in SOT, indicating the need for screening diagnosis (11,12).…”

Diarrhea in solid-organ transplant recipients: a review of the evidence

“…Several studies have reported a two-to three-fold increased risk for colorectal cancer in transplant recipients compared to the general population [170][171][172][173][174][175][176][177] . In transplant recipients, colorectal cancer may present at an earlier age and may be more aggressive 175,178 .…”