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Skin Cancer Examiniation

What is the Incidence and Risk Factors for Skin Cancer in Organ Transplant Recipients?

Organ transplant recipients (OTRs) are at greater risk of developing skin cancer than the general population.  This is likely due to the lifelong immunosuppressive regimes that are required to preserve graft function.

A recent study combined national transplant registry data with skin cancer outcomes to estimate a population-based incidence of post-transplant skin cancer in the United States. In addition, the authors sought to evaluate the risk factors for post-transplant skin cancer, including squamous cell carcinoma (SCC), melanoma (MM), and Merkel cell carcinoma (MCC). The study population included 10,649 adults who received a primary transplant in either 2003 or 2008, and this population yielded more than 59,000 person years of follow-up data.

A total of 8% of the OTRs studied developed post-transplant skin cancer. The incidence rate (IR) of overall skin cancer (calculated per 100,000 person-years of observation) was considered high, with an overall rate of 1,437 per 100,000 person years. Most of the cancers were SCC; OTRs had an IR of 1,355 per 100,000 person-years compared to 38 per 100,000 in the general adult population. Cases of MCC and MM were also significantly higher that what is observed in the general US population.

The authors state that the data show the skin cancer incidence rate in OTRs is nearly 5 times the rate of all cancers combined in the overall US population. OTR patients that were white, men, thoracic transplant recipients or 50 years or older at transplant were at higher risk for developing skin cancer. The authors conclude that the high incidence of post-transplant skin cancer highlights the need for surveillance after organ transplantation, especially in certain OTRs with high-risk features. They note that future research should include the development of a prediction tool and research to determine whether skin cancer risk can be mitigated through optimization of immunosuppressive regimes.

 

Byline: Martha L. Sikes, MS, RPh, PA-C

Posted: May 8, 2017

Source: JAMA Dermatology
Adapted from the original article.

[Image: Shutterstock]




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