J Cancer 2017; 8(1):9-18. doi:10.7150/jca.16550
Epidemiology of cancer in end-stage renal disease dialysis patients: a national cohort study in Taiwan
1. Department of Nephrology, Chi-Mei Medical Center, Tainan, Taiwan.
2. Department of Food Nutrition, Chung-Hwa University of Medical Technology, Tainan, Taiwan.
3. Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China.
4. Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.
5. Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan.
6. Department of Recreation and Health-Care Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
7. Department of Anesthesiology, Chi-Mei Medical Center, Tainan, Taiwan.
8. Department of Occupational Safety and Health, Chung Hwa University of Medical Technology, Tainan, Taiwan.
9. Department of Endocrinology and Metabolism, Chi-Mei Medical Center, Tainan, Taiwan.
10. Department of Nephrology, Taipei Veterans General Hospital, Taiwan.
* These authors equally contributed to this work.
Chien CC, Han MM, Chiu YH, Wang JJ, Chu CC, Hung CY, Sun YM, Yeh NC, Ho CH, Lin CC, Kao HY, Weng SF. Epidemiology of cancer in end-stage renal disease dialysis patients: a national cohort study in Taiwan. J Cancer 2017; 8(1):9-18. doi:10.7150/jca.16550. Available from http://www.jcancer.org/v08p0009.htm
The incidence and mortality of site-specific cancers in patients with end-stage renal disease (ESRD) on maintenance dialysis have been rarely studied for Asian populations. We tapped Taiwan`s National Health Insurance Research Database to identify and recruit patients starting maintenance dialysis between 1999 and 2004. They were followed from initiation of dialysis until death, discontinuation of dialysis, or the end of 2008. We calculated the survival rate and mortality risk of dialysis patients with cancer. Of 40,833 dialysis patients, 2352 (5.8%) had been newly diagnosed with cancer. Being older, being male, and having chronic liver disease were factors associated with a higher risk for new cancer in ESRD dialysis patients. In men, liver cancer (20.63%) was the most frequent, followed by cancers of the bladder (16.88%) and kidney (11.61%). In women, bladder cancer (25.57%) was the most frequent, followed by cancers of the kidney (16.31%) and breast (11.20%). The 5-year survival rates for kidney and bladder cancer were higher than for other cancers; the survival rates for lung, stomach, and liver cancer were lower. In conclusion, the distribution of site-specific cancer was different between men and women in patients with ESRD on dialysis. More attention should be paid to teaching dialysis patients how to avoid the well-known cancer risks and carcinogens and individualized regular cancer screenings.
Keywords: Cancer, end-stage renal disease, incidence, dialysis.