Ratio of observed (O) to expected (E) cases and excess absolute risk of new invasive solid cancers, according to time since HCT
| . | Time since transplantation . | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| < 1 y . | 1-4 y . | 5-9 y . | 10 y or longer . | 15 y or longer . | . | . | Total . | . | ||||||
| No. of patients | 28 874 | 15 170 | 6 641 | 1985 | 378 | 28 874 | ||||||||
| Person-years at risk | 19 335 | 40 520 | 19 674 | 6054 | 1047 | 85 583 | ||||||||
| Subsequent cancer site | O | O/E | O | O/E | O | O/E | O | O/E | O | O/E | O | E | O/E (95% CI) | EAR‡ |
| All solid cancers* | 19 | 1.3 | 52 | 1.56§ | 51 | 2.78§ | 31 | 4.55§ | 5 | 3.28§ | 153 | 73.25 | 2.09§ (1.77-2.45) | 9.32 |
| Oral cavity and pharynx | 0 | 0 | 4 | 2.23 | 15 | 15.50§ | 8 | 25.69§ | 0 | 0 | 27 | 3.85 | 7.01§ (4.62-10.20) | 2.70 |
| Lip | 0 | 0 | 2 | 19.53§ | 2 | 37.34§ | 2 | 102.53§ | 0 | 0 | 6 | 0.22 | 26.78§ (10.01-59.36) | 0.68 |
| Tongue | 0 | 0 | 1 | 2.87 | 5 | 26.90§ | 4 | 63.12§ | 0 | 0 | 10 | 0.75 | 13.34§ (6.40-24.52) | 1.08 |
| Salivary gland | 0 | 0 | 0 | 0 | 4 | 58.37§ | 0 | 0 | 0 | 0 | 4 | 0.28 | 14.16§ (3.89-36.58) | 0.43 |
| Gum, other mouth | 0 | 0 | 1 | 2.18 | 2 | 8.08 | 2 | 24.76§ | 0 | 0 | 5 | 0.99 | 5.06§ (1.64-11.79) | 0.47 |
| Pharynx | 0 | 0 | 0 | 0 | 2 | 4.85 | 0 | 0 | 0 | 0 | 2 | 1.61 | 1.24 (0.15-4.49) | 0.05 |
| Esophagus | 0 | 0 | 2 | 4.63 | 0 | 0 | 1 | 13.58 | 1 | 69.5 | 3 | 0.93 | 3.24 (0.67-9.43) | 0.24 |
| Colon | 0 | 0 | 2 | 1.15 | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 3.83 | 0.52 (0.06-1.89) | −0.21 |
| Rectum, rectosigmoid jct, anus | 0 | 0 | 3 | 2.75 | 0 | 0 | 1 | 4.49 | 0 | 0 | 4 | 2.39 | 1.67 (0.46-4.29) | 0.19 |
| Liver | 1 | 4.49 | 2 | 3.87 | 1 | 3.66 | 3 | 31.41§ | 0 | 0 | 7 | 1.11 | 6.32§ (2.54-12.99) | 0.69 |
| Bronchus and lung | 1 | 0.69 | 4 | 1.22 | 3 | 1.68 | 0 | 0 | 0 | 0 | 8 | 7.18 | 1.11 (0.48-2.20) | 0.10 |
| Female breast | 1 | 0.32 | 5 | 0.67 | 2 | 0.47 | 5 | 3.19§ | 2 | 5.82 | 13 | 16.4 | 0.79 (0.42-1.36) | −0.94 |
| Female genital system | 1 | 0.69 | 3 | 0.88 | 4 | 2.05 | 1 | 1.35 | 1 | 6.17 | 9 | 7.56 | 1.19 (0.54-2.26) | 0.40 |
| Cervix | 1 | 1.64 | 3 | 2.16 | 0 | 0 | 1 | 3.74 | 1 | 18.9 | 5 | 3.03 | 1.65 (0.54-3.85) | 0.54 |
| Uterine corpus | 0 | 0 | 0 | 0 | 2 | 3.96 | 0 | 0 | 0 | 0 | 2 | 1.9 | 1.05 (0.13-3.80) | 0.03 |
| Testis | 0 | 0 | 2 | 1.33 | 0 | 0 | 1 | 3.19 | 0 | 0 | 3 | 3.35 | 0.90 (0.18-2.62) | −0.07 |
| Melanoma, skin | 4 | 3.75§ | 9 | 3.86§ | 2 | 1.58 | 3 | 5.79§ | 0 | 0 | 18 | 5.18 | 3.47§ (2.06-5.49) | 1.5 |
| Brain, CNS | 3 | 4.47 | 3 | 2.11 | 11 | 15.54§ | 1 | 4.30 | 0 | 0 | 18 | 3.03 | 5.94§ (3.52-9.39) | 1.75 |
| Thyroid | 3 | 5.42§ | 4 | 3.23 | 4 | 5.82§ | 5 | 17.76§ | 0 | 0 | 16 | 2.76 | 5.79§ (3.31-9.41) | 1.55 |
| Bones, joints | 0 | 0 | 3 | 8.98§ | 2 | 11.95§ | 1 | 20.46 | 1 | 126.46§ | 6 | 0.71 | 8.50§ (3.10-18.39) | 0.62 |
| Soft tissue | 1 | 4.25 | 2 | 4.03 | 4 | 15.72§ | 0 | 0 | 0 | 0 | 7 | 1.08 | 6.50§ (2.61-13.36) | 0.69 |
| Other solid cancers† | 4 | 1.42 | 4 | 0.63 | 3 | 0.88 | 1 | 0.78 | 0 | 0 | 12 | 13.9 | 0.86 (0.45-1.51) | −0.22 |
| . | Time since transplantation . | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| < 1 y . | 1-4 y . | 5-9 y . | 10 y or longer . | 15 y or longer . | . | . | Total . | . | ||||||
| No. of patients | 28 874 | 15 170 | 6 641 | 1985 | 378 | 28 874 | ||||||||
| Person-years at risk | 19 335 | 40 520 | 19 674 | 6054 | 1047 | 85 583 | ||||||||
| Subsequent cancer site | O | O/E | O | O/E | O | O/E | O | O/E | O | O/E | O | E | O/E (95% CI) | EAR‡ |
| All solid cancers* | 19 | 1.3 | 52 | 1.56§ | 51 | 2.78§ | 31 | 4.55§ | 5 | 3.28§ | 153 | 73.25 | 2.09§ (1.77-2.45) | 9.32 |
| Oral cavity and pharynx | 0 | 0 | 4 | 2.23 | 15 | 15.50§ | 8 | 25.69§ | 0 | 0 | 27 | 3.85 | 7.01§ (4.62-10.20) | 2.70 |
| Lip | 0 | 0 | 2 | 19.53§ | 2 | 37.34§ | 2 | 102.53§ | 0 | 0 | 6 | 0.22 | 26.78§ (10.01-59.36) | 0.68 |
| Tongue | 0 | 0 | 1 | 2.87 | 5 | 26.90§ | 4 | 63.12§ | 0 | 0 | 10 | 0.75 | 13.34§ (6.40-24.52) | 1.08 |
| Salivary gland | 0 | 0 | 0 | 0 | 4 | 58.37§ | 0 | 0 | 0 | 0 | 4 | 0.28 | 14.16§ (3.89-36.58) | 0.43 |
| Gum, other mouth | 0 | 0 | 1 | 2.18 | 2 | 8.08 | 2 | 24.76§ | 0 | 0 | 5 | 0.99 | 5.06§ (1.64-11.79) | 0.47 |
| Pharynx | 0 | 0 | 0 | 0 | 2 | 4.85 | 0 | 0 | 0 | 0 | 2 | 1.61 | 1.24 (0.15-4.49) | 0.05 |
| Esophagus | 0 | 0 | 2 | 4.63 | 0 | 0 | 1 | 13.58 | 1 | 69.5 | 3 | 0.93 | 3.24 (0.67-9.43) | 0.24 |
| Colon | 0 | 0 | 2 | 1.15 | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 3.83 | 0.52 (0.06-1.89) | −0.21 |
| Rectum, rectosigmoid jct, anus | 0 | 0 | 3 | 2.75 | 0 | 0 | 1 | 4.49 | 0 | 0 | 4 | 2.39 | 1.67 (0.46-4.29) | 0.19 |
| Liver | 1 | 4.49 | 2 | 3.87 | 1 | 3.66 | 3 | 31.41§ | 0 | 0 | 7 | 1.11 | 6.32§ (2.54-12.99) | 0.69 |
| Bronchus and lung | 1 | 0.69 | 4 | 1.22 | 3 | 1.68 | 0 | 0 | 0 | 0 | 8 | 7.18 | 1.11 (0.48-2.20) | 0.10 |
| Female breast | 1 | 0.32 | 5 | 0.67 | 2 | 0.47 | 5 | 3.19§ | 2 | 5.82 | 13 | 16.4 | 0.79 (0.42-1.36) | −0.94 |
| Female genital system | 1 | 0.69 | 3 | 0.88 | 4 | 2.05 | 1 | 1.35 | 1 | 6.17 | 9 | 7.56 | 1.19 (0.54-2.26) | 0.40 |
| Cervix | 1 | 1.64 | 3 | 2.16 | 0 | 0 | 1 | 3.74 | 1 | 18.9 | 5 | 3.03 | 1.65 (0.54-3.85) | 0.54 |
| Uterine corpus | 0 | 0 | 0 | 0 | 2 | 3.96 | 0 | 0 | 0 | 0 | 2 | 1.9 | 1.05 (0.13-3.80) | 0.03 |
| Testis | 0 | 0 | 2 | 1.33 | 0 | 0 | 1 | 3.19 | 0 | 0 | 3 | 3.35 | 0.90 (0.18-2.62) | −0.07 |
| Melanoma, skin | 4 | 3.75§ | 9 | 3.86§ | 2 | 1.58 | 3 | 5.79§ | 0 | 0 | 18 | 5.18 | 3.47§ (2.06-5.49) | 1.5 |
| Brain, CNS | 3 | 4.47 | 3 | 2.11 | 11 | 15.54§ | 1 | 4.30 | 0 | 0 | 18 | 3.03 | 5.94§ (3.52-9.39) | 1.75 |
| Thyroid | 3 | 5.42§ | 4 | 3.23 | 4 | 5.82§ | 5 | 17.76§ | 0 | 0 | 16 | 2.76 | 5.79§ (3.31-9.41) | 1.55 |
| Bones, joints | 0 | 0 | 3 | 8.98§ | 2 | 11.95§ | 1 | 20.46 | 1 | 126.46§ | 6 | 0.71 | 8.50§ (3.10-18.39) | 0.62 |
| Soft tissue | 1 | 4.25 | 2 | 4.03 | 4 | 15.72§ | 0 | 0 | 0 | 0 | 7 | 1.08 | 6.50§ (2.61-13.36) | 0.69 |
| Other solid cancers† | 4 | 1.42 | 4 | 0.63 | 3 | 0.88 | 1 | 0.78 | 0 | 0 | 12 | 13.9 | 0.86 (0.45-1.51) | −0.22 |
Includes all invasive second solid cancers excluding nonmelanoma skins; excludes 17 carcinomas in situ (lip [n = 1], rectum [n = 2], lung [n = 1], melanoma [n = 5], breast [n = 2], cervix [n = 3], vulva [n = 2], penis [n = 1]), and 19 invasive squamous cell skin cancers. Histologies of special interest: leiomyosarcoma of the small intestine (n = 1), angiosarcomas of the liver (n = 2) and fibrous histiocytomas of the liver (n = 2), high-grade sarcoma of the lung (n = 1), desmoplastic round cell tumor of the uterus (n = 1), and rhabdomyosarcoma of the cervix (n = 1). Two patients developed Kaposi sarcoma (1 of the digestive organs and the other of skin of the leg). The 4 cancers of the salivary gland were mucoepidermoid carcinomas. Two patients whose indication for HCT was neuroblastoma developed new second malignancies (1 bladder cancer, 1 thyroid cancer). The number of patients (person-years at risk [PYR]) for males was 17 122 (49 331 PYR) and for females was 11 752 (36 252 PYR).
Other solid cancers included leiomyosarcoma of the small intestine (n = 1), Kaposi sarcoma (n = 2), neuroendocrine cancer of the pancreas/duodenum (n = 1), neuroblastoma of nose/nasal cavities (n = 1), cancers of the prostate (n = 1), penis (n = 1), bladder (n = 1), kidney (n = 1), and metastatic carcinoma of unknown primary site (n = 3).
EAR is calculated by the number of observed cases minus the expected cases per 10 000 person-years at risk.
P < .05.