Tracking incidence and prognosis of lung cancer seen in kidney transplant recipients: A retrospective study.

• DOI: 10.1200/jco.2025.43.16_suppl.e23357
• Publication Date: 2025-05-28T15:17:35Z
• Authors: Samhita Boppana; Samhita Boppana; Het Patel; Neeraj Singh; Samip R. Master; Michael Vutam

e23357

Background: The incidence of malignancy in solid organ transplant recipients tends to be higher than in the general population. Malignancy is the third leading cause of death among transplant recipients. Although kidney transplant recipients may have improved survival and quality of life compared to dialysis patients, they are at a two-to-four times higher risk of developing malignancy. Furthermore, outcomes after the diagnosis of malignancy are not well described in the literature. In this study, we review the incidence of lung cancer in kidney transplant patients and track patient outcomes after diagnosis of malignancy. Methods: We perused UNOS/OPTN database and identified patients who received kidney transplants from January 2010 to December 2022. Exclusion criteria included transplants before the year 2010, no official diagnosis of malignancy, patients who received at least one solid organ transplant previously, or those who received multiple induction medications. We reviewed incidences of lung cancer both in the first 5 years post-transplant as well as between 5-10 years after the transplant procedure. The Kaplan–Meier method was used for time-to-event analysis (death-censored graft survival and patient survival analysis). Results: A total of 231,130 patients were identified with 12,764 (5.5%) suffering malignancy during post-transplant follow-up. Of these 12,764 patients, 1,416 (11.1%) of them were diagnosed with lung cancer. During the first 5 years post-transplant, the incidence of lung cancer in kidney transplant recipients was 9.2/10,000 person-years. Among these 1,416 recipients who developed lung cancer, 1,190 (84.0%) of these patients died during the 5-year follow-up period after diagnosis of malignancy, and the median survival time was 151 (45–373) days. Conclusions: Despite advances in screening, lung cancer remains a major cause of mortality and morbidity in post-transplant patients. Particularly, there is an increase in the incidence of lung cancer between 5-10 years after transplant, with median survival of less than one year. Although post-transplant cancer screening is almost identical to those recommended for the general population, the high incidence and poor prognosis may warrant a closer review and possible changes to the current guidelines. Further studies are indicated to assess if earlier detection of lung cancer through potentially updated screening methods may have an improved effect on the outcomes of patient survival in kidney transplant recipients.