TOPLINE

In a population-based study, the incidence of de novo cancer was associated with an increased risk for death among solid organ transplantation (SOT) recipients, with non-Hodgkin lymphoma showing the highest mortality.

METHODOLOGY

• Researchers conducted a population-based cohort study including 50,762 SOT recipients (60.8% male individuals; 76.1% White) from England between June 01, 1992, and December 31, 2015.
• Follow-up started 30 days post-transplant and continued until death due to cancer or another cause or until December 31, 2022.
• Standardised mortality ratios (SMRs) for cancer-related mortality were calculated overall and stratified by transplanted organ and cancer type.
• The cohort contributed 645,649 person-years at risk, with a median follow-up duration of 11.8 years.

TAKEAWAY

• Overall cancer-related mortality in SOT recipients was more than twice that in the general population (SMR, 2.12; 95% CI, 2.05-2.19), corresponding to 29 additional deaths per 10,000 person-years of follow-up.
• Non-Hodgkin lymphoma demonstrated the highest mortality (SMR, 9.86; 95% CI, 9.01-10.75), with an absolute excess risk of 6.8 per 10,000 person-years; however, several cancers including prostate, thyroid, cervical, and breast cancers showed no increased risk for mortality.
• Liver cancer mortality was markedly elevated among liver transplant recipients (SMR, 9.30; 95% CI, 7.53-11.24), and kidney cancer mortality was significantly elevated among kidney transplant recipients (SMR, 5.11; 95% CI, 4.34-5.93).
• Ethnicity was significantly associated with cancer-related mortality, with South Asian (incidence risk ratio [IRR], 0.59; 95% CI, 0.51-0.69), Black (IRR, 0.56; 95% CI, 0.45-0.70), and Chinese or East Asian (IRR, 0.55; 95% CI, 0.30-0.99) SOT recipients having a lower risk for cancer-related mortality than White recipients.

IN PRACTICE

"[The study] findings underscore the importance of long-term cancer vigilance and heightened clinical awareness for transplant recipients, particularly for high-risk cancers such as PTLD [posttransplantation lymphoproliferative disorder]," the authors wrote.

SOURCE

The study was led by Charlotte Stephens, Department of Nephrology and Transplantation, University Hospital Birmingham, Birmingham, England. It was published online on July 01, 2026, in the British Journal of Cancer.

LIMITATIONS

The study did not include individual-level factors such as immunosuppression regimens; dialysis vintage; participation in cancer screening programmes; and modifiable behavioural risk factors including smoking, alcohol use, and dietary habits. Non-melanoma skin cancer was excluded due to the known underreporting and inconsistent documentation within the National Cancer Registration and Analysis Service. Cancer-related mortality is influenced by both the incidence of cancer and postdiagnosis survival, which should have been considered simultaneously for the interpretation of the findings.

DISCLOSURES

The study was supported by the Kildare Trust and Wellcome Institutional Strategic Support Fund. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.