Document Type

Capstone Experience

Graduation Date

12-2018

Degree Name

Master of Public Health

Department

Epidemiology

First Committee Member

Dr. Veenu Minhas

Second Committee Member

Dr. Campbell Walter

Third Committee Member

Dr. Haynatzki Gleb

Abstract

Background: Chronic kidney disease (CKD) is an established risk factor for cardiovascular disease, but the significance of lower Glomerular filtration rate on incidence and mortality from cancer is uncertain. There is evidence that cancer risk and cancer mortality may be increased in individuals with End Stage Renal Disease (ESRD) requiring dialysis or after renal transplantation but whether less severe kidney disease is associated with cancer remains poorly understood.

Some studies indicate that these associations do appear to be organ specific. It has been reported that reduced renal function is associated with an increased risk of cancers of the kidney and Genito-urinary system, gastrointestinal, lung and some soft tissue and hematological cancers like myeloma.

Objectives: To characterize the Chronic Kidney Disease (CKD) patients by cancer incidents. Additionally, to calculate the crude and age-adjusted cancer incidence in individuals with compromised kidney function.

Methods: A retrospective cohort study was conducted using the electronic medical record information from the patients received treatment at Nebraska Medicine from 2008 to 2018, extracted by UNMC Public Health Informatics lab. The subjects with Chronic Kidney Disease and eventually advanced to cancer were included in the study (N=869). The subjects are characterized by descriptive comparison of age, gender, race, most frequent medical conditions, body mass index, smoking status, and frequently diagnosed cancer.

Results: The cohort is predominant with Caucasian (n=702; 80.78%) male (n=486; 55.93%) population with median age 71 (IQR: 63.53). Major proportion of the individuals in the cohort are obese (n=283; 32.57%). The frequent cancer types among the cohort are digestive (n=129; 14.85%), urinary (n=105; 12.08%), respiratory (n=96; 11.05%), skin (n=95; 10.93%) and leukemia (n=90; 10.36%). The crude/age-adjusted incidence of the frequently observed cancer groups was exponentially higher than the national, state and the city estimates.

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