Different patterns of cancer incidence among African American and Caucasian renal allograft recipients.

Background: Little data are available regarding cancer incidence in separately analyzed African American renal allograft recipients, with no study examining in detail the incidence and relative distribution of individual post-transplant malignancies versus those occurring in Caucasians.

Methods: We compared the incidence of nonskin cancer occurring in 495 African Americans transplanted at our center from 1984 to 2007 and followed through June 2009 with that occurring in 11,155 patients in the Canadian Organ Replacement Registry transplanted from 1981 to 1998 and followed through December 1999, of which 97% were Caucasian.

Results: Despite a shorter follow-up, the overall incidence of nonskin cancer, as well as that of prostate, renal cell, pancreatic, and esophageal cancer, was significantly higher in the African American group. Cancers of the prostate and pancreas comprised a significantly higher fraction of neoplasms occurring in the African American group, whereas lip cancer did so in the Canadian Organ Replacement Registry group.

Conclusion: In our pilot study, the overall incidence of nonskin cancers was higher in African American versus Caucasian renal allograft recipients, reflecting a significantly different relative distribution of cancer types that follows cancer incidence trends by race in the general population in several but not all cases. If verified in subsequent studies, these findings have important implications with regard to the need for transplant programs to tailor cancer education and pretransplant and post-transplant surveillance appropriately to the African American patient.