Original InvestigationDialysisCancer Incidence Among US Medicare ESRD Patients Receiving Hemodialysis, 1996-2009
Section snippets
Data and Population
We used data from the USRDS, a national registry that includes all patients in Medicare’s ESRD program. The study population included patients with ESRD 18 years or older who received in-center hemodialysis within the period from April 1, 1995, through December 31, 2010. The study population was restricted to individuals with Medicare as their primary payer and both Parts A and B coverage in order to ensure collection of complete claims data for patients. Patients were excluded for a history of
Annual Incidence Rates of Cancer
Table 1 lists characteristics of the study population of prevalent dialysis patients for selected years of the study period. The number of patients per annual cohort increased each year, from 88,676 in 1996 to 164,214 in 2009. Patients were more likely to be male, be white, or have diabetes as the primary cause of ESRD in recent cohorts. Mean age and mean dialysis vintage increased during the study period.
Adjusted annual incidence rates of cancer are presented in Fig 1. We observed a constant
Discussion
We conducted a large national study of patients with ESRD undergoing hemodialysis to describe the incidence of cancer in this population. After accounting for the substantial competing risk of death in the ESRD population undergoing dialysis, we observed a high cumulative incidence of cancer, with >9% of the ESRD population being diagnosed with cancer during a 5-year period after initiating dialysis therapy. From 1996 through 2009, we observed constant rates of incident cancer diagnoses for all
Acknowledgements
Some of the data reported in this study have been supplied by the USRDS. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the US government.
Support: This research was supported by the National Institutes of Health through contracts from the National Institute of Diabetes and Digestive and Kidney Diseases (2 T32 DK007750-15), the National Cancer Institute (5 T32 CA009330-30), the National
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