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2017 ; 28
(2
): 393-399
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Cancer risk among 21st century blood transfusion recipients
#MMPMID28426101
Yang TO
; Cairns BJ
; Reeves GK
; Green J
; Beral V
Ann Oncol
2017[Feb]; 28
(2
): 393-399
PMID28426101
show ga
BACKGROUND: Some carcinogenic viruses are known to be transmissible by blood
transfusion. Intensive viral screening of transfused blood now exists in most
countries. In the UK, high-sensitivity nucleic acid amplification tests for
hepatitis C virus were introduced in 1999 and it was thought that this would
reduce, and possibly eliminate, transfusion-related liver cancer. We aimed to
investigate cancer risk in recipients of blood transfusion in 2000 or after.
METHODS: A total of 1.3 million UK women recruited in 1998 on average were
followed for hospital records of blood transfusion and for cancer registrations.
After excluding women with cancer or precancerous conditions before or at the
time of transfusion, Cox regression yielded adjusted relative risks of 11
site-specific cancers for women with compared to without prior blood transfusion.
RESULTS: During follow up, 11 274 (0.9%) women had a first recorded transfusion
in 2000 or after, and 1648 (14.6%) of them were subsequently diagnosed with
cancer, a mean 6.8 years after the transfusion. In the first 5 years after
transfusion there were significant excesses for most site-specific cancers
examined, presumably because some had preclinical cancer. However, 5 or more
years (mean 8 years) after blood transfusion, there were significant excess risks
only for liver cancer (adjusted relative risk?=?2.63, 95%CI 1.45-4.78) and for
non-Hodgkin lymphoma (adjusted relative risk?=?1.74, 1.21-2.51). When analyses
were restricted to those undergoing hip or knee replacement surgery, the
commonest procedure associated with transfusion, these relative risks were not
materially altered. CONCLUSIONS: In a large cohort of UK women, transfusions in
the 21st century were associated with long-term increased risks of liver cancer
and non-Hodgkin lymphoma. Some of these malignancies may have been caused by
carcinogenic agents that are not currently screened for in transfused blood.