Ekstrom M, et al. - Lung transplant recipients with COPD were assessed for the incidence as well as prognosis of cancer. Findings reported a markedly increased cancer risk in COPD patients who underwent lung transplantation (LTx). Furthermore, it could not be predicted by the factors evaluated, but contributed significantly to a negative prognosis.

Methods

• Researchers performed a prospective, population-based study of patients undergoing LTx for end-stage COPD at the two transplantation centers in Sweden between 1990-2013.
• They used national registers for follow-up, mainly focusing on the incidence of cancer and death.
• Furthermore, the excess risk of cancer was calculated as standardized incidence ratios compared with the general population matched for age, sex, and calendar year.
• Using Fine-Gray regression, they assessed risk factors for cancer and, Kaplan–Meier was used to analyze survival after cancer diagnosis.

Results

• This study included overall 331 patients (mean age 55.4 years; 64% women; 97% former smokers).
• Cancer was detected in 35% of patients at a median follow-up of 2.8 years and at the same time, the reported risk was increased more than 10-fold ([95% CI] 8.1-11.8).
• Data showed that the highest excess risks were for non-Hodgkin lymphoma (20.8-66.7), skin cancer (20.3-35.2), lung (11.7-31.2), liver (3.6-51.6), and colorectal cancer (6.1-19.5).
• Researchers observed that median survival was longer for skin cancer (8 years; 95% CI, 3-15) compared with non-skin cancer (4 years; 95% CI, 2.8-4.8; p<0.001).