A retrospective study of the incidence of cancer and associated risk factors in kidney transplant patients in a Latin American population between 2007 and 2022

Background: Kidney transplantation is the ideal treatment for patients with end-stage renal disease. However, this population has a higher risk of cancer. This highlights the importance of early screening to improve outcomes in the detection of neoplasms, associated risk factors, and prompt treatment in this population. Objectives: The objective of this study is to determine the incidence and risk factors associated with post-transplant cancer. Methods: This was a historical analytical cohort observational study that evaluated the incidence of cancer and associated risk factors in kidney transplant recipients in the Clínica Universitaria Colombia program between 2007 and 2022. Result: A total of 555 patients were included, with a predominance of males (61.1%). An incidence of posttransplant cancer was documented in n = 79 (14%) patients at a follow-up of 84.7 months, with skin neoplasms in n = 33 (41.7%) of cases, followed by solid organ neoplasms n = 31 (39.2%). Associated risk factors identified were age at the time of transplantation being statistically significant (Hazard ratio (HR): 1.04; 95% confidence interval (CI): 1.02–1.06), a history of cancer prior to kidney transplantation (HR: 3.62; 95% CI: 1.46–8.99), and diabetes mellitus (HR: 2.08; 95% CI: 1.24–3.49). A statistically significant relationship was documented as a protective factor for mammalian Target of Rapamicyn (mTOR) inhibitors and solid organ neoplasms with relative risk (RR) 0.414 (95% CI: 0.19–0.88). No increase of posttransplant lymphoproliferative disorder (PTLD) was found with co-stimulation signal inhibitor-based therapy. Conclusions: In a Latin American kidney transplant cohort the incidence of post-transplant malignancy was found to be 14% in a median follow-up of 7 years. This study found that risk factors include age, history of cancer prior to transplantation, and diabetes mellitus. Use of mTOR pathway inhibitors was associated with a reduced risk of solid organ neoplasms. No increase in the frequency of PTLD was found in patients receiving costimulation signal inhibitors.