Risk of de novo prostate cancer diagnosis after solid organ transplant: A retrospective claims-based matched cohort study

Introduction

Immunosuppression in solid organ transplant patients raises concerns for de novo cancer development. However, research has been limited by small sample sizes or lack of matching. This study used a claims database to assess risk of prostate cancer in transplant patients compared to the general population.

Methods

The TriNetX Research Network was queried for men without history of prostate cancer who underwent solid organ transplant (kidney, heart/lung, liver, or pancreas) between ages 50–59, 60–69, and 70–79. Transplant patients were matched by age and PSA-screening to controls who did not have a history of solid organ transplant or prostate cancer.

Results

After matching, there were 59,701 patients in each arm for the 50–59 cohort, 66,801 per arm for the 60-69 cohort, and 34,187 per arm for the 70–79 cohort. For all 3 transplant cohorts, the relative risk of a prostate cancer diagnosis was significantly lower than for their age-matched controls through 10 years after solid organ transplant. When stratified by organ type, men with kidney or liver transplants had a lower risk of prostate cancer compared to controls. Men with heart/lungs or pancreas transplants had risk similar to controls.

Conclusions

The decreased long-term risk of a prostate cancer diagnosis in transplant patients compared to matched controls highlights the likely value of pretransplant PSA screening and the lack of any clearly increased prostate cancer risk related to immunosuppressive medication in this population. Additional studies are needed to clarify any relationship between prostate cancer and transplantation and post-transplant screening recommendations.