No significant association between immunosuppression in solid organ transplantation and prostate cancer risk: a meta-analysis of cohort studies

Transl Cancer Res. 2019 Jun;8(3):939-949. doi: 10.21037/tcr.2019.06.03.

Abstract

Background: It is known that organ transplant recipients have a significantly higher risk for developing cancers, but the association between immunosuppression in organ transplantation and the risk for prostate cancer (PCa) remains unclear. We aimed to assess the evidence regarding the association of solid organ transplantation with PCa risk.

Methods: A literature search of the PubMed, Embase, and Web of Science databases was performed up to March 2019. Combined relative risks (RRs) and 95% confidence intervals (CIs) were calculated by using a fixed-effect or random-effect model.

Results: In total, 26 articles including 33 independent population-based cohort studies with 556,812 recipients and 2,438 PCa cases were identified and included in this meta-analysis. PCa risk in the solid organ transplant recipients did not increase compared with the general population (RR=1.04; 95% CI: 0.90-1.18). Independent analysis of different kinds of organ replacements further indicated immune inhibition in the transplantation of kidney, liver, heart, and lung, and was not associated with elevated PCa risk (RR=0.89; 95% CI: 0.83-0.95; RR=0.61, 95% CI: 0.21-1.02; RR=1.70, 95% CI: 0.88-2.52; RR=0.87, 95% CI: 0.57-1.16, respectively).

Conclusions: This study demonstrated that immunosuppression in solid organ transplant recipients was not associated with higher PCa risk.

Keywords: Prostate cancer (PCa); immunosuppression; meta-analysis; solid organ transplantation; standardized incidence ratio.