Kidney Week

Abstract: SA-OR71

Increased Risk of Cancer in Glomerular Diseases: A Population-Level Analysis

Session Information

• Glomerular Diseases: Clinical Advances
  October 26, 2024 | Location: Room 6D, Convention Center
  Abstract Time: 05:40 PM - 05:50 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Han, Jialin, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada

Jialin Han

• Zhao, Yinshan, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada

Yinshan Zhao, PhD

• Canney, Mark, University of Ottawa, Ottawa, Ontario, Canada

Mark Canney, MD, PhD

• Atiquzzaman, Mohammad, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada

Mohammad Atiquzzaman, PhD

• Levin, Adeera, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada

Adeera Levin, MD

• Barbour, Sean, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada

Sean Barbour, MD, MS, MSc

Background

Patients with glomerular disease (GN) may be at an increased risk of cancer due to immunosuppression, chronic inflammation and infection with oncogenic viruses. However, there is limited epidemiologic data such that the absolute risk of cancer and cancer-related risk factors in GN remain unknown.

Methods

We conducted a population-level analysis of all adults with biopsy-proven GN in British Columbia, Canada from 2000 to 2020, using a centralized pathology database linked to a provincial cancer database. Age- and sex- standardized incidence ratios (SIR) of cancer events were calculated. Kaplan-Meier curves were used to describe time to the first cancer event.

Results

The cohort comprised 4,006 patients, including IgAN (N=1200), membranous nephropathy (MN, N=542), FSGS (N=770), MCD (N=364), lupus nephritis (LN, N=528) and ANCA-GN (N=602). During a median of 7.9 years follow up, cancer events occurred in 386 patients (9.6%) including colon (N=56), lung (N=50), prostate (N=45), breast (N=24), kidney (N=23), lymphoma (N=22) and cervical (N=19) cancer. Those with cancer had more severe disease activity, with lower eGFR (45.3 vs 57.2 ml/min/1.73m²) and higher proteinuria (2.5 vs 2.0 g/day), and more comorbidity burden at baseline. The risk of cancer was increased compared to the general population (SIR 1.5), including age groups 20-40, 40-60, 60-80, and >80 years (SIR 6.6, 1.7, 1.4 and 1.2 respectively). The risk of cancer was increased in ANCA-GN, FSGS, MN and MCD compared to IgAN or LN (Figure 1).

Conclusion

Patients with GN have an increased risk of cancer compared to the general population, particularly amongst younger patients who have a longer life expectancy and may benefit most from improved cancer screening. The risk of cancer varied by disease activity and type of GN, both of which may be correlated with immunosuppression use. Future steps will be to investigate risk factors for cancer in GN, including the type and extent of immunosuppression exposure.