Table 3.
Multivariate associations between transplant factors and colorectal cancer incidence among transplant recipients, overall and by anatomic sub-site
| Characteristic | All CRC (n=790) IRR (95% CI) |
Proximal colon (n=408) IRR (95% CI) |
Distal colon (n=195) IRR (95% CI) |
Rectum (n=146) IRR (95% CI) |
|---|---|---|---|---|
| Organ and medical condition | ||||
| Kidney | Reference | Reference | Reference | Reference |
| Heart | 0.99 (0.79, 1.23) | 1.18 (0.87, 1.59) | 0.75 (0.48, 1.17) | 0.92 (0.55, 1.54) |
| Liver, no PSC | 1.03 (0.85, 1.25) | 1.32 (1.01, 1.73) | 0.64 (0.42, 0.96) | 1.01 (0.65, 1.58) |
| Liver, PSC without IBD | 2.72 (1.64, 4.52) | 3.78 (1.97, 7.25) | 2.29 (0.83, 6.31) | 1.67 (0.41, 6.91) |
| Liver, PSC and IBD | 5.32 (3.73, 7.58) | 7.91 (5.03, 12.5) | 3.43 (1.56, 7.52) | 2.08 (0.64, 6.72) |
| Lung, no CF | 1.88 (1.33, 2.64) | 2.07 (1.30, 3.32) | 1.72 (0.85, 3.47) | 1.65 (0.70, 3.90) |
| Lung, CF | 12.3 (6.94, 21.9) | 17.8 (7.91, 40.1) | 16.2 (5.95, 44.3) | 2.93 (0.39, 22.1) |
| Other or multiple | 1.08 (0.71, 1.63) | 1.52 (0.88, 2.65) | 0.63 (0.23, 1.74) | 0.83 (0.35, 2.00) |
| Time since transplant | ||||
| <2 years | Reference | Reference | Reference | Reference |
| 2 – <4 years | 1.10 (0.89, 1.37) | 1.19 (0.88, 1.60) | 1.05 (0.68, 1.62) | 1.03 (0.63, 1.68) |
| 4 – <6 years | 1.20 (0.95, 1.52) | 1.24 (0.89, 1.72) | 1.13 (0.70, 1.83) | 1.26 (0.74, 2.14) |
| 6 – <8 years | 1.23 (0.94, 1.60) | 1.10 (0.75, 1.61) | 1.65 (0.99, 2.73) | 0.99 (0.51, 1.94) |
| 8 – <12 years | 1.86 (1.43, 2.42) | 1.51 (1.04, 2.19) | 2.05 (1.21, 3.48) | 2.49 (1.39, 4.47) |
| >=12 years | 1.91 (1.30, 2.79) | 1.82 (1.09, 3.04) | 1.76 (0.78, 3.97) | 2.04 (0.80, 5.18) |
| Induction medication | ||||
| None | Reference | Reference | Reference | Reference |
| Any | 0.97 (0.82, 1.15) | 1.10 (0.87, 1.39) | 0.78 (0.55, 1.10) | 0.81 (0.55, 1.20) |
| Maintenance medications | ||||
| Tacrolimus/MMF | Reference | Reference | Reference | Reference |
| Cyclosporine/azathioprine | 1.14 (0.87, 1.48) | 1.53 (1.05, 2.23) | 0.76 (0.45, 1.29) | 0.87 (0.47, 1.59) |
| Other | 1.04 (0.85, 1.28) | 1.29 (0.96, 1.73) | 0.82 (0.54, 1.24) | 0.85 (0.54, 1.35) |
| Calendar year of transplant | ||||
| 1987–1994 | Reference | Reference | Reference | Reference |
| 1995–2002 | 1.06 (0.71, 1.59) | 1.12 (0.62, 2.02) | 1.17 (0.53, 2.56) | 0.98 (0.39, 2.46) |
| 2003–2006 | 0.88 (0.56, 1.39) | 1.26 (0.66, 2.40) | 0.73 (0.30, 1.78) | 0.57 (0.20, 1.62) |
| 2007–2010 | 0.69 (0.43, 1.13) | 0.79 (0.39, 1.58) | 0.58 (0.22, 1.51) | 0.61 (0.20, 1.84) |
Model are adjusted for age (modeled with one degree of freedom across categories of 0–17, 18–34, 35–49, 50–64, and 65+ years), sex, Hispanic ethnicity, body mass index (underweight, normal weight, overweight, obese, missing), and diabetes mellitus (yes, no, missing).
CRC=colorectal cancer; CF=cystic fibrosis; PSC=primary sclerosing cholangitis; IBD=inflammatory bowel disease; MMF=mycophenolate mofetil; IRR=incidence rate ratio; CI=confidence interval