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- Title
Cancer risk among elderly persons with end-stage renal disease: a population-based case-control study.
- Authors
Shebl, Fatma M.; Warren, Joan L.; Eggers, Paul W.; Engels, Eric A
- Abstract
Background: Patients with end-stage renal disease (ESRD) have elevated cancer risk. Cancer risk increases with age, but associations of ESRD with specific malignancies are incompletely studied for older individuals. Methods: We conducted a population-based case-control study (1,029,695 cancer and 99,610 controls) among the U.S. elderly using SEER-Medicare linked data. We defined ESRD as presence of dialysis claims in the 3 months prior to selection. Results: Although ESRD was not associated with excess cancer risk overall (odds ratio 1.02; 95%CI 0.91-1.14), risk was specifically increased for cancers of the stomach (1.45; 1.16-1.81), small intestine (1.92; 1.27-2.92), colon (1.17; 1.00-1.36), liver (1.53; 1.16-2.01), biliary tract (1.78; 1.20-2.65), lung (1.17; 1.02-1.34), cervix (2.12; 1.39-3.23), kidney (2.42; 2.01-2.92), and for multiple myeloma (1.77; 1.40-2.24) and chronic myeloid leukemia (1.74; 1.08-2.80). The association between liver cancer and ESRD was attenuated upon adjustment for hepatitis B and C infection or diabetes mellitus. Multiple myeloma risk was highest with short ESRD duration (p<0.0001), possibly reflecting reverse causality, while kidney cancer risk showed a borderline rise over time (p = 0.08). Conclusions: Among elderly individuals with ESRD, the excess risks for some cancers may reflect immune dysfunction or a high prevalence of other risk factors, such as viral infections or diabetes mellitus. Our results underscore the need for studying biological pathways of carcinogenesis in ESRD.
- Subjects
CANCER risk factors; CANCER patients; KIDNEY diseases; DIABETES; HEALTH insurance
- Publication
BMC Nephrology, 2012, Vol 13, Issue 1, p65
- ISSN
1471-2369
- Publication type
Article
- DOI
10.1186/1471-2369-13-65