Incidence Risk of Various Types of Digestive Cancers in Patients with Pre-dialytic Chronic Kidney Disease: A Nationwide Population-based Cohort Study

Although renal dysfunction is associated with a higher incidence of malignancies, there is no research on the incidence of specific types of digestive cancer in pre-dialytic chronic kidney disease (CKD) patients compared to the general population. This study was conducted on newly diagnosed pre-dialytic CKD patients (n = 35,443) between 2003 and 2013 using the National Health Insurance Service-National Sample Cohort in Korea. The risk of digestive cancer development in pre-dialytic CKD patients was calculated as the standardized incidence ratio (SIR). During a median follow-up of 54.9 months, the risk of digestive cancer in CKD patients was significantly higher than in the cohort population [SIR; 1.54, 95% confidence interval (95% CI); 1.46-1.62], the SIR of pancreatic cancer was 2.21, and the SIRs of hepatoma, colorectal cancer (CRC), bile duct cancer, and gastric cancer were 2.01, 1.60, 1.40, and 1.25, respectively. Moreover, in CKD patients younger than 40 years, the incidence ratios of hepatoma and CRC were remarkably larger compared with the cohort population of the same age (SIR; 5.98 in hepatoma, 4.58 in CRC). However, the incidence of specific types of digestive cancer seemed to be similar, irrespective of sex. In conclusion, digestive cancers were more frequently observed in CKD-diagnosed patients compared with a cohort population in Korea, which suggests that physicians should closely monitor their patients for the incidence of digestive cancer when they are diagnosed with CKD.