Abstract for presentation at Australia and New Zealand Society of Nephrology Annual Scientific Conference

** Cancer among Australians receiving dialysis treatment – outcome of data matching between ANZDATA and the National Cancer Statistics Clearing House (NCSCH)

  • Dr Stephen McDonald, ANZDATA Registry, Adelaide, Australia
  • Dr Claire Vajdic, National Centre for HIV Epidemiology and Clinical Research, Sydney, Australia
  • Ms Marina van Leeuwen, National Centre for HIV Epidemiology and Clinical Research, Sydney, Australia
  • Dr Margaret McCredie, University of Otago, Australia
  • Dr John Stewart, ANZDATA Registry, Adelaide, Australia
  • Dr Angela Webster, University of Sydney, Australia
  • Prof Jeremy Chapman, University of Sydney, Australia
  • A/Prof Andrew Grulich, National Centre for HIV Epidemiology and Clinical Research, Sydney, Australia

    • ANZDATA has recorded cancers since 1971. States also mandate reporting to cancer registries and since 1982 to NCSCH, whose data are used as the community standard. Using probabilistic matching and appropriate ethical safeguards, ANZDATA and NCSCH datasets were matched, creating a de-identified dataset. Rates were calculated for NCSCH-registered cancers (except non-melanocytic skin cancer), allowing comparisons within the same dataset between those receiving dialysis with the general population, and also with those who had been transplanted. Presented are standardized incidence ratios (SIRs), adjusted for age, gender, state/territory of residence and yearof cancer; all analyses were censored at the time of first transplant.
    Among dialysis patients, rates of all cancers were increased compared with the general population, more so among females (SIR 1.91 [95% CI 1.74-2.09]) than males (SIR 1.50 [1.39-1.62]). This effect remained once cancers associated with the cause of ESRD (renal tract/myeloma) were excluded (SIR 1.37 [1.28-1.46]). There was variation in the risk between cancer sites: rates of colonic and rectal cancer, leukemia, melanoma, uterine and ovarian cancer were not increased, whereas rates of lung (SIR 1.59 [1.34-1.88]), breast (in females, SIR 1.25 [1.0-1.55]), cervical (SIR 2.58 [1.50-4.45]) and thyroid cancer (SIR 9.23 [6.72-12.68] were increased. However, rates of prostate cancer were lower (SIR 0.71 [0.57-0.89]).
    There is a modest but definite increase in rates of cancer among people receiving dialysis treatment. The cause is unclear, but may relate to the immunosuppressive effect of uraemia. The possibility of increased diagnostic surveillance in this medically supervised population should also be noted.

    Conference Organiser - ICMS Pty Ltd