Abstract: FR-OR81
Cancer Incidence and Outcomes in the Dialysis Population: Nationwide Registry Analysis of Time Trends and Outcomes
Session Information
- Onconephrology: Models, Markers, and Medications
October 25, 2024 | Location: Room 33, Convention Center
Abstract Time: 05:50 PM - 06:00 PM
Category: Onconephrology
- 1700 Onconephrology
Authors
- Elyan, Benjamin Michael Peter, University of Glasgow College of Medical Veterinary and Life Sciences, Glasgow, United Kingdom
- Nimmo, Ailish, NHS Lothian, Edinburgh, Edinburgh, United Kingdom
- Mark, Patrick Barry, University of Glasgow College of Medical Veterinary and Life Sciences, Glasgow, United Kingdom
- Lees, Jennifer S., University of Glasgow College of Medical Veterinary and Life Sciences, Glasgow, United Kingdom
- Bell, Samira, University of Dundee School of Medicine, Dundee, United Kingdom
Background
Individuals with end-stage kidney disease have an increased risk of developing and dying from cancer compared to the general population. It is unclear how cancer incidence has changed over time. We aimed to assess cancer incidence over time in the Scottish dialysis population.
Methods
The cohort comprised of adults receiving chronic dialysis (haemodialysis or peritoneal dialysis) in Scotland between 1997-2021. Data were linked between the Scottish Renal Registry, Scottish Cancer Registry and mortality records. Cancers were defined using the International Classification of Diseases for Oncology, 3rd Edition with codes C00-C80, excluding non-melanomatous skin cancer (C44). Cancer incidence rates per 1000 population-years (IRs) were calculated per 5-year time periods and cox regression analyses were performed to examine factors associated with the development of de-novo cancer.
Results
Of 9003 people on long-term dialysis,727 developed de novo cancer. Median follow-up was longer for people with de-novo cancer (3.6 years vs 2.6 years, p <0.001). The most common cancers were lung (22.8%), colorectal (13.1%), haematological (7.8%), breast (6.7%) and bladder (6.7%). Incidence rate of cancer from 1997-2001 was 19.2 per 1000 patient-years. IRs for later time periods were higher (Figure). The IRR for 2017-2021 was 2.58 compared to the reference period (1997-2001). Increased hazards of de novo cancer were observed with older age at dialysis initiation (aHR 1.01 per year, 95% CI: 1.00-1.02, p=0.001) and with a diagnosis of glomerular diseases compared with other primary renal diagnoses (aHR 1.28, 95% CI 1.01-1.62, p=0.046).
Conclusion
Incidence rates of cancer in the Scottish dialysis population are increasing. These findings emphasise the importance of understanding the role of cancer screening, diagnosis and treatment pathways in dialysis patient care.
Cancer incidence rates in the dialysis population over 5-year period.