Transplant Question 10 Instructor

Which cancers are increased in risk post-transplant? What are the risk factors for cancer post-transplant, and what are the recommendations for cancer screening post-transplant?

Transplant recipients are at greater risk of developing cancer compared to the general population. This is particularly true for cancers associated with viral infections (e.g. EBV-associated lymphomas, cervical cancer associated with HPV, and Kaposi’s sarcoma associated with HHV-8). The risk also varies by organ transplanted. For example, cancers associated with chronic kidney disease and end-stage renal disease (e.g. myeloma and renal cell carcinoma) are seen more commonly in kidney transplant recipients, while the incidence of lung cancer is highest in lung transplant recipients compared to other organs. The relative risk for other common cancers, such as breast, colon, thyroid and prostate is either similar to or only moderately increased compared to the general population.

There is good reason to believe that the value of cancer screening tests, harm from interventions and the life-years to be gained by early intervention may be substantially different in transplant recipients compared to that in the general population. Hence, careful individual appraisal needs to be exercised when making recommendations for screening post-transplant.

Finally, it should be noted that the most common type of cancer post-transplant is squamous-cell skin cancer. Because of this, all transplant recipients are advised to use sun protection year-round, and either perform regular self-checks for new skin lesions or have regular examinations by their family doctor or dermatologist.

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