Lung transplant patients face elevated lung cancer risk

In an American Journal of Transplantation study, lung cancer risk was increased after lung transplantation, especially in the native (non-transplanted) lung of single lung transplant recipients.

This was a large registry-linkage study that utilized matched transplant and cancer registry data from 17 US states/regions, including approximately 50 percent of US transplant recipients from 1987-2012. Researchers found that patients with a single lung transplant had a 13-fold increased risk of lung cancer in the native lung compared with similar persons without a lung transplant in the general population.

Risk factors for the development of lung cancer in the native lung included those typically associated with lung cancer (older age, prior smoking, and pulmonary fibrosis), as well as longer time since transplantation. Compared with cases in the general population, lung cancers in transplant recipients were more frequently of a localized stage and were treated surgically; however, recipients had higher all-cause and cancer-specific mortality.

“Lung cancer is the most common cancer (except for skin cancers) to arise after lung transplant, and this study is one of the first to quantify that risk, examine risk factors, and explore survival in the lung transplant population using a large national cohort,” said lead author Dr. Matthew Triplette, of the Fred Hutchinson Cancer Research Center and the University of Washington, in Seattle. “These findings have important implications in understanding long-term risks among lung transplant recipients.”

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