Aims: To compare the risk of non-skin cancers after exposure to immunosuppressants between renal transplant recipients (RTRs) and patients with glomerular disease (GD).

Background: To date, there is no previous comparison on the risk of non-skin cancers between RTRs and patients with GD treated with long-term Immunosuppressants.

Methods: A retrospective cohort study was undertaken among adult RTRs with first-time kidney graft and GD patients in Central and Central West Queensland, Australia.

Results: The cohort comprised of 61 RTRs and 51 GD patients followed up over a median duration of 74.0 months (Interquartile range, IQR 44.5–110.5) and 52.5 months (IQR 29.8–81.8) after exposure to immunosuppressants, respectively (p = 0.088). Between two cohorts, no statistical differences were noted between baseline demographics except duration and intensity of immunosuppressants. RTRs were treated with more intense and lengthy immunosuppressive therapy compared to GD patients. Three renal cell carcinoma (RCC), two prostate carcinoma, two colorectal carcinoma (CRC), and one sarcoma of chest were found in RTRs whereas 2 RCCs and 1 CRC in GD group. The cumulative incidence of solid cancers in RTRs and GD and 11.5% (N = 7) and 5.9% (N = 3), respectively. One RTR developed post-transplant lymphoproliferative disorder affecting the scalp. No haematological malignancy was reported in GD cohort. The mean age of patients at the time of cancer diagnosis and mean onset of cancer was 47 years (RTRs) versus 67 years (patients with GD), and 133 versus 147 months, respectively.

Conclusions: Immunosuppressants may increase the risk of solid cancers in both cohorts. Higher cancer risk is likely dependent on the intensity and duration of immunosuppressants.