Evidence map›Paper›PMID 41758511›Full record

ArticleJAMA network open2026

Erythropoiesis-Stimulating Agents and Development of Cancer Among Patients Receiving Dialysis.

Jae Young Kim, Jae Kwang Lee, Tae Ik Chang, Hyung Woo Kim

Erratum issuedAbstract read
In one paragraph

Article in JAMA network open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Wording Change in Introduction.JAMA network open · 2026
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Jae Young KimDepartment of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si, Republic of Korea.
Jae Kwang LeeResearch and Analysis Team, National Health Insurance Service Ilsan Hospital, Goyang-si, Republic of Korea.
Tae Ik ChangDepartment of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si, Republic of Korea.
Hyung Woo KimDepartment of Internal Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Republic of Korea.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: Although erythropoiesis-stimulating agents (ESAs) are widely used to treat anemia in patients with kidney failure, concerns have been raised about their potential to promote tumor growth. However, the association between ESA use and incidence of cancer in patients undergoing long-term dialysis remains unclear. Objective: To examine the association between ESA use and cancer development among patients receiving long-term dialysis. Design, Setting, and Participants: This nested case-control study identified patients in the Korean National Health Insurance Service database with kidney failure who began long-term dialysis treatment and received ESAs between 2006 and 2017 in Korea. Each case with incident cancer was matched with 4 controls based on age, sex, follow-up time, year of dialysis initiation, and dialysis modality. Data were analyzed between August 2024 and August 2025. Exposure: ESA exposure was categorized as high or low dose according to the median of the mean weekly dose of each ESA drug. Main Outcomes and Measures: The primary outcome was newly diagnosed cancer occurring 6 months after the initiation of long-term dialysis. Conditional logistic regression, adjusted for potential confounders, was used to assess the association between ESA use and cancer development. Results: A total of 9776 patients (mean [SD] age, 62.2 [12.0] years; 6296 [64.4%] male) undergoing dialysis were included; 2320 patients with incident cancer were matched to 7456 controls. After multivariable adjustment, high-dose ESA use was found to be associated with increased odds of cancer development (adjusted odds ratio, 1.23; 95% CI, 1.11-1.35) compared with low-dose use. Stratified by age, the odds of cancer development were 0.90 (95% CI, 0.77-1.05) among patients aged younger than 60 years and 1.47 (95% CI, 1.30-1.67) among those aged 60 years or older. Conclusions and Relevance: In this case-control study of patients undergoing dialysis, high-dose ESA use was associated with greater odds of new cancer development. These results suggest that caution should be exercised to avoid aiming for excessively high hemoglobin levels during ESA therapy.

Indexed as

AnemiaHematinicsKidney Failure, ChronicNeoplasmsRenal DialysisAgedCase-Control StudiesFemaleHumansIncidenceMaleMiddle AgedRepublic of KoreaRisk FactorsHematinics

Identifiers

PMID41758511
PMCPMC12949436

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.