M THAI1,5, M MCGRAIL3, T HAN1,3, F STARR1, S Y AUNG2,3, Z THET1,3,4
1Department of Nephrology, Central Queensland Hospital and Health Service, Rockhampton, Australia, 2Department of Oncology, Central Queensland Hospital and Health Service, Rockhampton, Australia, 3University of Queensland Rural Clinical School, Rockhampton, Australia, 4School of Medicine, Griffith University, Nathan, Australia, 5Northside Clinical Unit – School of Medicine, University of Queensland, Chermside, Australia
Aim: To identify the prevalence of solid organ and haematological malignancies in Central Queensland (CQ) and compare the cancer rates between CQ-dialysis patients with the general population of CQ and Australasian dialysis population.
Background: In Australia, an estimated 145,000 new cancer cases are diagnosed annually, with 1,300 cases in CQ. We postulate that CQ-dialysis patients have increased cancer risk because of various intrinsic and extrinsic risk factors unique to chronic kidney disease and CQ.
Method: We conducted a single-centered, retrospective study of cancer incidence, excluding skin cancers, that arise during dialysis in CQ within a 10-year period (2009–2019).
Results: Among 174 (107 males, 66 females) dialysis patients, 26 (14%) patients were diagnosed with cancer at any point in time — 9 (5%) of which were diagnosed during dialysis. All patients were Caucasian. The mean age at cancer diagnosis was 71.9±10.6(SD). The average onset of cancer post-dialysis commencement was 5.04 years (95%CI 3.59-6.49). Cancer types included renal(n=4), esophageal(n=2) and other(n=3). No haematological malignancy was identified. The annual cancer incidence rate in the general CQ population and CQ-dialysis cohort were 533 and 1373 per 100,000 people, respectively. The cancer incidence in the CQ-dialysis population was 13.7 per 1000 dialysis-years (95%CI 6.7-25.2). Similar incidence was reported in Australasian dialysis population at 12.9 per 1000 dialysis-years. Cancer standardized incidence rate (SIR) between CQ-dialysis patients and the general CQ population was 1.09 (95%CI 0.50-2.08) and that of CQ dialysis patients and the Australasian dialysis cohort was 1.06 (95%CI 0.48-2.03).
Conclusion: Our study showed no significant difference in cancer incidence rates between cancer incidence rates in CQ-dialysis patients, when compared with the general CQ population, or the Australasian dialysis cohort.
Dr Maxter Thai is a second-year medical resident for Queensland Health. He is an alumnus of the University of Queensland School of Medicine. After obtaining his medical degree, he completed his internship training rurally at the Central Queensland Hospital and Health Service in Rockhampton. Following this, he relocated to the Prince Charles Hospital to begin his Basic Physician Training under the Royal Australasian College of Physicians. On the side, he has also recently taken up a teaching role as a lecturer at the Northside Clinical Unit at the University of Queensland School of Medicine.