Cancer Risk in Haemodialysis Patients Compared With That in the General Population: A Multicenter Questionnaire-Based Study in Okinawa, Japan.

AIM: Dialysis patients face a heightened risk of cancer, particularly kidney cancer. The global aging of dialysis patients suggests that managing cancer may become a critical factor in future healthcare. Given that the chronic uremic state is a cancer risk factor, dialysis patients may face an elevated risk for all cancers. However, the epidemiology of nonkidney cancers, such as colorectal cancer, remains to be fully elucidated.

METHODS

This was a retrospective cohort study targeting 74 dialysis facilities in Okinawa Prefecture, Japan. The subjects were patients who received dialysis for a minimum of 90 days between 2015 and 2019 and were diagnosed with cancer after initiating dialysis during this period. The cancer incidence ratio for the study population (21 655 person-years) was then compared with that of the general Okinawan population using standardized incidence ratios.

RESULTS

A total of 404 cancer cases were collected from 56 facilities (76%). The standardized incidence ratios for all cancers was 1.36, with the risk of kidney cancer increasing with longer dialysis vintage. Patients with a dialysis vintage of less than 2 years showed an increased risk of colorectal and lung cancer. The risk of breast cancer was similar to that of the general population.

CONCLUSION

The present study revealed that not all cancer risks were increased among patients receiving haemodialysis. Screening for colorectal and lung cancer in the first 2 years after commencement of dialysis may be important. Further research is needed to determine the efficacy of this approach for patients receiving dialysis.