Cancer diagnosis after living kidney donation: linking U.S. registry data and administrative claims.
Lentine, K.L., Vijayan, A., Xiao, H., Schnitzler, M.A., Davis, C.L., Garg, A.X., ... Brennan, D.C. (2012). Transplantation, 94(2), 139-144. doi:10. 1097/TP.0b013e318253f1bc
U.S. Organ Procurement and Transplantation Network (OPTN) data were linked to administrative data from a private insurance company to determine the burden of cancer among living kidney donors. The impetus for this study included the increase in living donors and mortality data identifying cancer as the leading cause of death among prior kidney donors. Follow-up data maintained by the OPTN ceases two years after the transplant, necessitating the need to use another data source for comparison. Once the living donor was identified, a gender- and age-matched control was identified, and correlational data were used to determine cancer rates. As a single correlational study, these results provide Level IV data (Polit & Beck, 2012).
Demographically, the 4,650 donors, which comprised the study population, were primarily female (54.6%), Caucasian (76.3%), 37 years of age, and biologically related to the recipient (81%). Four conclusions were identified by these authors: 1) the overall frequency of non-skin cancer was lower among these donors, and skin cancer rates were similar; 2) the relative cancer risk for non-skin cancers dissipated over time and was thought to be the result of the screening activities associated with donation; 3) several cases of cancer occurred within the first year after donation; and 4) prostate cancer was significantly more common among these living donors than their control counterparts.
Historically, Caucasians are more apt to receive a kidney transplant than African Americans, even though kidney disease is more prevalent among African Americans. Rates of prostate cancer are higher among African Americans; therefore, the identification of an increased rate of prostate cancer when using a predominately Caucasian and female study population may have clinical significance. While surveillance activities surrounding prostate cancer are inconclusively supported, these results appear to identify an at-risk population. Male living kidney donors should be made aware of the increased post-operative risk for prostate cancer. Males who have donated a kidney should receive routine screening because their donation may have increased their vulnerability to this disease.
Ward-Smith, P. (2013). Abstracts. Urologic Nursing, 33(3), 148-150. doi: 10.7257/1053-816X.2013.33.3.148
Key Words: Prostate cancer, living kidney donation, organ transplant, incorrect surgical counts, quality improvement, catheter-associated urinary tract infection, health-information-seeking behavior.
Peggy Ward-Smith, PhD, RN, is Director, Faculty Center for Excellence in Teaching (FACET), University of Missouri-Kansas City, and an Associate Professor, School of Nursing, University of Missouri, Kansas City, MO, and a member of the Urologic Nursing Editorial Board.
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|Date:||May 1, 2013|
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