Risk Factors for Skin Cancer Among Transplant Recipients
Skin cancer following organ transplantation is common in the United States, with increased age, being Caucasian or male.
Skin cancer following organ transplantation is common in the United States, with increased age, being Caucasian or male, and undergoing thoracic organ transplantation each conferring an elevated risk, according to a study published in JAMA Dermatology.1
Previous research demonstrated that the most common type of malignancy occurring after organ transplantation is skin cancer. Although data were reported showing the increased risk of skin cancer among solid organ transplant recipients, the post-transplant population-based incidence of skin cancer in the United States was not evaluated.
For this study, researchers determined the incidence of, and assessed the risk factors for, post-transplant skin cancer, including squamous cell carcinoma (SCC), melanoma, and Merkel cell carcinoma (MCC), in a cohort of organ transplant recipients who received a primary organ transplant.
For this multicenter, retrospective study, investigators analyzed data from 10,649 adult recipients of a primary organ transplant performed at 26 centers across the US in the Transplant Skin Cancer Network during 2003 or 2008. Researchers included recipients of all organs except intestine for their analysis.
The incidence rate for post-transplant skin cancer was 1408 per 100,000 person-years. For SCC, melanoma, and MCC, the specific subtypes rates were 1328, 122, and 4 per 100,000 person-years, respectively.
Pre-transplant skin cancer (hazard ratio [HR], 4.69; 95% CI, 3.26-6.73), male sex (HR, 1.56; 95% CI, 1.34-1.81), Caucasian race (HR, 9.04; 95% CI, 6.20-13.18), age at transplant 50 years or older (HR, 2.77; 95% CI, 2.20-3.48), and being transplanted in 2008 vs 2003 (HR, 1.53; 95% CI, 1.22-1.94) were independent factors associated with an elevated risk for developing skin cancer post-transplantation.
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These findings highlight the importance of tumor surveillance following organ transplantation, especially among those with high-risk features. These data can help to inform risk stratification and screening guidelines for skin cancer among organ transplant recipients. The investigators aim, using these results, to develop a prediction tool for post-transplant skin cancer.
- Garrett GL, Blanc PD, Boscardin J, et al. Incidence of and risk factors for skin cancer in organ transplant recipients in the United States. JAMA Dermatol. 2017 Jan 11. doi: 10.1001/jamadermatol.2016.4920 [Epub ahead of print]