Cancer incidence in blood transfusion recipients.

Henrik Hjalgrim, Gustaf Edgren, Klaus Rostgaard, Marie Reilly, Trung Nam Tran, Kjell Titlestad, Agneta Shanwell, Casper Jersild, Johanna Adami, Agneta Wikman, Gloria Gridley, Louise Wideroff, Olof Nyrén, Mads Melbye

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

BACKGROUND: Blood transfusions may influence the recipients' cancer risks both through transmission of biologic agents and by modulation of the immune system. However, cancer occurrence in transfusion recipients remains poorly characterized. METHODS: We used computerized files from Scandinavian blood banks to identify a cohort of 888,843 cancer-free recipients transfused after 1968. The recipients were followed from first registered transfusion until the date of death, emigration, cancer diagnosis, or December 31, 2002, whichever came first. Relative risks were expressed as ratios of the observed to the expected numbers of cancers, that is, standardized incidence ratios (SIRs), using incidence rates for the general Danish and Swedish populations as a reference. All statistical tests were two-sided. RESULTS: During 5,652,918 person-years of follow-up, 80,990 cancers occurred in the transfusion recipients, corresponding to a SIR of 1.45 (95% confidence interval [CI] = 1.44 to 1.46). The SIR for cancer overall decreased from 5.36 (95% CI = 5.29 to 5.43) during the first 6 months after transfusion to 1.10 or less for follow-up periods more than 2 years after the transfusion. However, the standardized incidence ratios for cancers of the tongue, mouth, pharynx, esophagus, liver, and respiratory and urinary tracts and for squamous cell skin carcinoma remained elevated beyond 10 years after the transfusion. CONCLUSIONS: The marked increase in cancer risk shortly after a blood transfusion may reflect the presence of undiagnosed occult cancers with symptoms that necessitated the blood transfusion. The continued increased risk of tobacco- and alcohol-related cancers suggests that lifestyle and other risk factors related to conditions prompting transfusion rather than transfusion-related exposures per se are important to the observed cancer occurrence in the recipients
Udgivelsesdato: 2007-Dec-19
OriginalsprogEngelsk
TidsskriftJNCI - Journal of the National Cancer Institute
Vol/bind99
Udgave nummer24
Sider (fra-til)1864-74
Antal sider11
ISSN0027-8874
DOI
StatusUdgivet - 19. dec. 2007

Citer dette

Hjalgrim, H., Edgren, G., Rostgaard, K., Reilly, M., Tran, T. N., Titlestad, K., ... Melbye, M. (2007). Cancer incidence in blood transfusion recipients. JNCI - Journal of the National Cancer Institute, 99(24), 1864-74. https://doi.org/10.1093/jnci/djm248
Hjalgrim, Henrik ; Edgren, Gustaf ; Rostgaard, Klaus ; Reilly, Marie ; Tran, Trung Nam ; Titlestad, Kjell ; Shanwell, Agneta ; Jersild, Casper ; Adami, Johanna ; Wikman, Agneta ; Gridley, Gloria ; Wideroff, Louise ; Nyrén, Olof ; Melbye, Mads. / Cancer incidence in blood transfusion recipients. I: JNCI - Journal of the National Cancer Institute. 2007 ; Bind 99, Nr. 24. s. 1864-74.
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title = "Cancer incidence in blood transfusion recipients.",
abstract = "BACKGROUND: Blood transfusions may influence the recipients' cancer risks both through transmission of biologic agents and by modulation of the immune system. However, cancer occurrence in transfusion recipients remains poorly characterized. METHODS: We used computerized files from Scandinavian blood banks to identify a cohort of 888,843 cancer-free recipients transfused after 1968. The recipients were followed from first registered transfusion until the date of death, emigration, cancer diagnosis, or December 31, 2002, whichever came first. Relative risks were expressed as ratios of the observed to the expected numbers of cancers, that is, standardized incidence ratios (SIRs), using incidence rates for the general Danish and Swedish populations as a reference. All statistical tests were two-sided. RESULTS: During 5,652,918 person-years of follow-up, 80,990 cancers occurred in the transfusion recipients, corresponding to a SIR of 1.45 (95{\%} confidence interval [CI] = 1.44 to 1.46). The SIR for cancer overall decreased from 5.36 (95{\%} CI = 5.29 to 5.43) during the first 6 months after transfusion to 1.10 or less for follow-up periods more than 2 years after the transfusion. However, the standardized incidence ratios for cancers of the tongue, mouth, pharynx, esophagus, liver, and respiratory and urinary tracts and for squamous cell skin carcinoma remained elevated beyond 10 years after the transfusion. CONCLUSIONS: The marked increase in cancer risk shortly after a blood transfusion may reflect the presence of undiagnosed occult cancers with symptoms that necessitated the blood transfusion. The continued increased risk of tobacco- and alcohol-related cancers suggests that lifestyle and other risk factors related to conditions prompting transfusion rather than transfusion-related exposures per se are important to the observed cancer occurrence in the recipients Udgivelsesdato: 2007-Dec-19",
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author = "Henrik Hjalgrim and Gustaf Edgren and Klaus Rostgaard and Marie Reilly and Tran, {Trung Nam} and Kjell Titlestad and Agneta Shanwell and Casper Jersild and Johanna Adami and Agneta Wikman and Gloria Gridley and Louise Wideroff and Olof Nyr{\'e}n and Mads Melbye",
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Hjalgrim, H, Edgren, G, Rostgaard, K, Reilly, M, Tran, TN, Titlestad, K, Shanwell, A, Jersild, C, Adami, J, Wikman, A, Gridley, G, Wideroff, L, Nyrén, O & Melbye, M 2007, 'Cancer incidence in blood transfusion recipients.', JNCI - Journal of the National Cancer Institute, bind 99, nr. 24, s. 1864-74. https://doi.org/10.1093/jnci/djm248

Cancer incidence in blood transfusion recipients. / Hjalgrim, Henrik; Edgren, Gustaf; Rostgaard, Klaus; Reilly, Marie; Tran, Trung Nam; Titlestad, Kjell; Shanwell, Agneta; Jersild, Casper; Adami, Johanna; Wikman, Agneta; Gridley, Gloria; Wideroff, Louise; Nyrén, Olof; Melbye, Mads.

I: JNCI - Journal of the National Cancer Institute, Bind 99, Nr. 24, 19.12.2007, s. 1864-74.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Cancer incidence in blood transfusion recipients.

AU - Hjalgrim, Henrik

AU - Edgren, Gustaf

AU - Rostgaard, Klaus

AU - Reilly, Marie

AU - Tran, Trung Nam

AU - Titlestad, Kjell

AU - Shanwell, Agneta

AU - Jersild, Casper

AU - Adami, Johanna

AU - Wikman, Agneta

AU - Gridley, Gloria

AU - Wideroff, Louise

AU - Nyrén, Olof

AU - Melbye, Mads

PY - 2007/12/19

Y1 - 2007/12/19

N2 - BACKGROUND: Blood transfusions may influence the recipients' cancer risks both through transmission of biologic agents and by modulation of the immune system. However, cancer occurrence in transfusion recipients remains poorly characterized. METHODS: We used computerized files from Scandinavian blood banks to identify a cohort of 888,843 cancer-free recipients transfused after 1968. The recipients were followed from first registered transfusion until the date of death, emigration, cancer diagnosis, or December 31, 2002, whichever came first. Relative risks were expressed as ratios of the observed to the expected numbers of cancers, that is, standardized incidence ratios (SIRs), using incidence rates for the general Danish and Swedish populations as a reference. All statistical tests were two-sided. RESULTS: During 5,652,918 person-years of follow-up, 80,990 cancers occurred in the transfusion recipients, corresponding to a SIR of 1.45 (95% confidence interval [CI] = 1.44 to 1.46). The SIR for cancer overall decreased from 5.36 (95% CI = 5.29 to 5.43) during the first 6 months after transfusion to 1.10 or less for follow-up periods more than 2 years after the transfusion. However, the standardized incidence ratios for cancers of the tongue, mouth, pharynx, esophagus, liver, and respiratory and urinary tracts and for squamous cell skin carcinoma remained elevated beyond 10 years after the transfusion. CONCLUSIONS: The marked increase in cancer risk shortly after a blood transfusion may reflect the presence of undiagnosed occult cancers with symptoms that necessitated the blood transfusion. The continued increased risk of tobacco- and alcohol-related cancers suggests that lifestyle and other risk factors related to conditions prompting transfusion rather than transfusion-related exposures per se are important to the observed cancer occurrence in the recipients Udgivelsesdato: 2007-Dec-19

AB - BACKGROUND: Blood transfusions may influence the recipients' cancer risks both through transmission of biologic agents and by modulation of the immune system. However, cancer occurrence in transfusion recipients remains poorly characterized. METHODS: We used computerized files from Scandinavian blood banks to identify a cohort of 888,843 cancer-free recipients transfused after 1968. The recipients were followed from first registered transfusion until the date of death, emigration, cancer diagnosis, or December 31, 2002, whichever came first. Relative risks were expressed as ratios of the observed to the expected numbers of cancers, that is, standardized incidence ratios (SIRs), using incidence rates for the general Danish and Swedish populations as a reference. All statistical tests were two-sided. RESULTS: During 5,652,918 person-years of follow-up, 80,990 cancers occurred in the transfusion recipients, corresponding to a SIR of 1.45 (95% confidence interval [CI] = 1.44 to 1.46). The SIR for cancer overall decreased from 5.36 (95% CI = 5.29 to 5.43) during the first 6 months after transfusion to 1.10 or less for follow-up periods more than 2 years after the transfusion. However, the standardized incidence ratios for cancers of the tongue, mouth, pharynx, esophagus, liver, and respiratory and urinary tracts and for squamous cell skin carcinoma remained elevated beyond 10 years after the transfusion. CONCLUSIONS: The marked increase in cancer risk shortly after a blood transfusion may reflect the presence of undiagnosed occult cancers with symptoms that necessitated the blood transfusion. The continued increased risk of tobacco- and alcohol-related cancers suggests that lifestyle and other risk factors related to conditions prompting transfusion rather than transfusion-related exposures per se are important to the observed cancer occurrence in the recipients Udgivelsesdato: 2007-Dec-19

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Blood Banks

KW - Blood Transfusion

KW - Child

KW - Child, Preschool

KW - Denmark

KW - Female

KW - Humans

KW - Incidence

KW - Infant

KW - Infant, Newborn

KW - Life Style

KW - Lymphoma, Non-Hodgkin

KW - Male

KW - Middle Aged

KW - Neoplasms

KW - Risk Assessment

KW - Risk Factors

KW - Scandinavia

KW - Sweden

U2 - 10.1093/jnci/djm248

DO - 10.1093/jnci/djm248

M3 - Journal article

C2 - 18073377

VL - 99

SP - 1864

EP - 1874

JO - National Cancer Institute. Journal (Print)

JF - National Cancer Institute. Journal (Print)

SN - 0027-8874

IS - 24

ER -