Declining incidence of keratinocyte carcinoma in organ transplant recipients

Menzies, Stephanie; O’Leary, Eamonn; Callaghan, Grainne; Galligan, Marie; Deady, Sandra; Gadallah, B.; Lenane, Patsy; Lally, Aoife; Houlihan, Diarmuid D.; Morris, Patrick G.; Sexton, Donal J.; McCormick, Peter; Egan, Jim; O’Neill, James Paul; Conlon, Peter J.; Moloney, Fergal J.

doi:10.1111/bjd.18094

Cited by 29 publications

(29 citation statements)

References 25 publications

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“…The reduction in the risk of SCC in our study is consistent with the results of a Norwegian nationwide cohort study 17 . A recent study in Ireland reported significant reduction over the past two decades in the incidences of both post‐transplant SCC and BCC 18 …”

Section: Discussionsupporting

confidence: 91%

Twenty‐eight‐year incidence and characteristics of post‐transplant skin cancers: Comparative analysis of past and recent 10‐year experience

Kim¹,

Jung²,

Park

et al. 2020

The Journal of Dermatology

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Because primary skin cancers in organ transplant recipients are rare, little is known about the characteristics and risk factors for skin cancers in organ transplant recipients. We searched the Asan Medical Center database of 13 469 organ transplant recipients for cases of all skin cancers from January 1990 to December 2018. Characteristics of and risk factors for skin cancers were analyzed and compared according to the period of transplantation. Of the identified 113 patients with skin cancers, squamous cell carcinoma was the most common cancer followed by basal cell carcinoma and Kaposi sarcoma. The cumulative incidence of skin cancers at 28 years was 5.3%. Over the 10-year period from January 2009 to December 2018, the standardized incidence ratio for premalignant in situ skin lesions increased, whereas the standardized incidence ratio for skin cancers decreased. Age at transplantation and treatment with more than two immunosuppressive agents were risk factors for the development of new skin cancers in organ transplant recipients. Over the most recent 10-year period, post-transplant skin cancers have been found earlier and diversified compared with in the previous period.

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Section: Discussionsupporting

confidence: 91%

Twenty‐eight‐year incidence and characteristics of post‐transplant skin cancers: Comparative analysis of past and recent 10‐year experience

Kim¹,

Jung²,

Park

et al. 2020

The Journal of Dermatology

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“…With the prevalence of BCC and SCC (including Bowen’s disease) being 13 and 30%, the SCC/BCC ratio was 2.6/1, similar to that in other studies in SOTRs, that is, an approximate reversal of the ratio of 1/4 found in the general population [3, 4, 9]. The prevalence of actinic keratosis and skin cancer has recently been reported to be high in Australian lung transplant recipients, [10] although the risk of skin cancer following solid organ transplantation in European countries has been shown to be declining over the last decades [11, 12].…”

Section: Discussionsupporting

confidence: 80%

Dermatological Disease in Australian Heart and Lung Transplant Recipients

et al. 2020

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Background: Research examining skin disease in heart and lung transplant recipients in Australia is limited. This study aims to determine the spectrum of skin diseases encountered in Australian heart and lung transplant recipients, their effect on quality of life, and potential risk factors for skin cancer. Methods: Ninety-four participants were recruited from an Australian heart and lung transplant centre between March and December 2016. The participants were asked to fill out a questionnaire which included the Dermatology Life Quality Index and were examined for malignant and non-malignant skin disease. The association of study variables with the presence of skin cancer and Dermatology Life Quality Index score were examined using logistic regression analysis. Results: A dermatological diagnosis was made in 82 patients (87%). Actinic keratosis was the most common diagnosis, affecting 50 participants (53%), followed by skin cancer (41; 44%) and warts (14; 15%). Other non-malignant skin diseases were less common. Risk factors associated with skin cancer on multivariate modelling included age at transplantation and a history of ≥5 post-transplant skin cancers. Skin disease had a negative effect on the quality of life of a minority of patients. Conclusion: Actinic keratosis and skin cancer are very frequent in Australian heart and lung transplant recipients and more common than non-malignant skin diseases. Routine dermatological surveillance at regular intervals is advised.

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“…Organ-transplant recipients (OTRs) have a dramatically increased risk of keratinocyte cancers (KCs), especially basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), compared with the general population. They have up to seven times increased risk for BCC and between 20 and 100 times for SCC compared with the general population (Garrett et al, 2017;Lowenstein et al, 2017;Menzies et al, 2019;Park et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Polygenic Risk Scores Allow Risk Stratification for Keratinocyte Cancer in Organ-Transplant Recipients

Seviiri

Law

Ong

et al. 2021

Journal of Investigative Dermatology

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Organ-transplant recipients have an elevated risk of keratinocyte cancers: basal cell carcinoma (BCC) and squamous cell carcinoma. We assessed whether polygenic risk scores (PRSs) generated in nontransplantees from the UK Biobank and 23andMe (13,981 squamous cell carcinoma, 33,736 BCC, and >560,000 controls) can predict keratinocyte cancer risk in an independent organ-transplant recipient cohort. After adjusting for traditional risk factors, compared with the bottom 20%, organ-transplant recipients in the top 20% PRS had an increased risk of BCC (OR ¼ 3.25, 95% confidence interval ¼ 1.44e7.31, P ¼ 4.4 Â 10-3) and squamous cell carcinoma (OR ¼ 2.11, 95% confidence interval ¼ 0.98e4.53, P ¼ 0.055). For BCC, the top 20% PRS individuals had an absolute risk of 23%, whereas the risk in the bottom 20% was similar to that in the general nontransplantee population. Adding PRS to a model containing traditional skin cancer risk factors yielded a 3% increase in the area under the curve for receiver operating characteristic curve for BCC (0.73 vs. 0.70); adding the PRS did not significantly increase the area under the curve for receiver operating characteristic curve for squamous cell carcinoma. Organ-transplant recipients in the highest genetic risk quintile could benefit from more intense keratinocyte cancer screening and preventive strategies compared with their counterparts. The BCC PRS improves prediction over and above the traditional skin cancer risk factors by 3%.

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Declining incidence of keratinocyte carcinoma in organ transplant recipients

Abstract: This summary relates to https://doi.

Cited by 29 publications

References 25 publications

Twenty‐eight‐year incidence and characteristics of post‐transplant skin cancers: Comparative analysis of past and recent 10‐year experience

Twenty‐eight‐year incidence and characteristics of post‐transplant skin cancers: Comparative analysis of past and recent 10‐year experience

Dermatological Disease in Australian Heart and Lung Transplant Recipients

Polygenic Risk Scores Allow Risk Stratification for Keratinocyte Cancer in Organ-Transplant Recipients

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