Increased cancer risk in kidney transplant patients in Scotland: a national registry linkage study

TY - JOUR

T1 - Increased cancer risk in kidney transplant patients in Scotland

T2 - a national registry linkage study

AU - Nimmo, Ailish

AU - Eylan, Benjamin

AU - Lakey, Joe

AU - Marjoribanks, Stephen

AU - Methven, Shona

AU - Morrison, David

AU - Bell, Samira

N1 - Publisher Copyright: © The Author(s) 2025.

PY - 2025/9/7

Y1 - 2025/9/7

N2 - Background Cancer is a major contributor to morbidity following kidney transplantation. This study examines the incidence of cancer in kidney transplant recipients (KTRs) in Scotland, compares this to the general population, and identifies factors associated with cancer development. Methods This nationwide cohort study utilised data from the Scottish Renal Registry, Scottish Cancer Registry and hospitalisation records. Standardised incidence rate ratios (SIRs) compared cancer incidence to the general population. Cox proportional hazards models identified factors associated with post-transplant cancer. Results Between 1997-2021, 4033 patients >18 years received a first kidney transplant. 770 developed cancer versus 194 expected (SIR 3.9, 95% CI 3.7–4.2). Site-specific SIRs were greatest for non-melanomatous skin cancer, lymphoma and kidney cancer. Cancer incidence was 7-times that of the general population in KTRs under 40, the increased incidence fell to 3-times for KTRs over 60. Differences in the incidence of the most common cancers in the general population (colorectal, lung, breast, prostate) were not detected in this population. Conclusions There is an increased risk of cancer in KTRs, particularly younger individuals. Non-melanomatous skin cancers are the most frequent cancer even in a population with low natural UV exposure. Tailored counselling and surveillance strategies are needed to improve patient outcomes.

AB - Background Cancer is a major contributor to morbidity following kidney transplantation. This study examines the incidence of cancer in kidney transplant recipients (KTRs) in Scotland, compares this to the general population, and identifies factors associated with cancer development. Methods This nationwide cohort study utilised data from the Scottish Renal Registry, Scottish Cancer Registry and hospitalisation records. Standardised incidence rate ratios (SIRs) compared cancer incidence to the general population. Cox proportional hazards models identified factors associated with post-transplant cancer. Results Between 1997-2021, 4033 patients >18 years received a first kidney transplant. 770 developed cancer versus 194 expected (SIR 3.9, 95% CI 3.7–4.2). Site-specific SIRs were greatest for non-melanomatous skin cancer, lymphoma and kidney cancer. Cancer incidence was 7-times that of the general population in KTRs under 40, the increased incidence fell to 3-times for KTRs over 60. Differences in the incidence of the most common cancers in the general population (colorectal, lung, breast, prostate) were not detected in this population. Conclusions There is an increased risk of cancer in KTRs, particularly younger individuals. Non-melanomatous skin cancers are the most frequent cancer even in a population with low natural UV exposure. Tailored counselling and surveillance strategies are needed to improve patient outcomes.

KW - Kidney transplantation

KW - cancer

KW - registry analysis

UR - https://www.scopus.com/pages/publications/105007988296

U2 - 10.1038/s41416-025-03086-2

DO - 10.1038/s41416-025-03086-2

M3 - Article

C2 - 40517146

SN - 0007-0920

VL - 133

SP - 555

EP - 563

JO - British Journal of Cancer

JF - British Journal of Cancer

IS - 4

ER -