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Incidence of and Risk Factors for Skin Cancer in Organ Transplant Recipients in the United States
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Garrett, Giorgia L.Blanc, Paul D.
Boscardin, John
Lloyd, Amanda Abramson
Ahmed, Rehana L.
Anthony, Tiffany
Bibee, Kristin
Breithaupt, Andrew
Cannon, Jennifer
Chen, Amy
Cheng, Joyce Y.
Chiesa-Fuxench, Zelma
Colegio, Oscar R
Curiel-Lewandrowski, Clara
Del Guzzo, Christina A.
Disse, Max
Dowd, Margaret
Eilers, Robert
Ortiz, Arisa Elena
Morris, Caroline
Golden, Spring K.
Graves, Michael S.
Griffin, John R.
Hopkins, R. Samuel
Huang, Conway C.
Bae, Gordon Hyeonjin
Jambusaria, Anokhi
Jennings, Thomas A.
Jiang, Shang I. Brian
Karia, Pritesh S.
Khetarpal, Shilpi
Kim, Changhyun
Klintmalm, Goran
Konicke, Kathryn
Koyfman, Shlomo A.
Lam, Charlene
Lee, Peter
Leitenberger, Justin J.
Loh, Tiffany
Lowenstein, Stefan
Madankumar, Reshmi
Moreau, Jacqueline F.
Nijhawan, Rajiv I.
Ochoa, Shari
Olasz, Edit B.
Otchere, Elaine
Otley, Clark
Oulton, Jeremy
Patel, Parth H.
Patel, Vishal Anil
Prabhu, Arpan V.
Pugliano-Mauro, Melissa
Schmults, Chrysalyne D.
Schram, Sarah
Shih, Allen F.
Shin, Thuzar
Soon, Seaver
Soriano, Teresa
Srivastava, Divya
Stein, Jennifer A.
Sternhell-Blackwell, Kara
Taylor, Stan
Vidimos, Allison
Wu, Peggy
Zajdel, Nicholas
Zelac, Daniel
Arron, Sarah T.
Affiliation
Univ Arizona, Med CtrIssue Date
2017-03-01
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AMER MEDICAL ASSOCCitation
Incidence of and Risk Factors for Skin Cancer in Organ Transplant Recipients in the United States 2017, 153 (3):296 JAMA DermatologyJournal
JAMA DermatologyRights
© 2017, American Medical Association.Collection Information
This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.Abstract
IMPORTANCE Skin cancer is the most common malignancy occurring after organ transplantation. Although previous research has reported an increased risk of skin cancer in solid organ transplant recipients (OTRs), no study has estimated the posttransplant population-based incidence in the United States. OBJECTIVE To determine the incidence and evaluate the risk factors for posttransplant skin cancer, including squamous cell carcinoma (SCC), melanoma (MM), and Merkel cell carcinoma (MCC) in a cohort of US OTRs receiving a primary organ transplant in 2003 or 2008. DESIGN, SETTING, AND PARTICIPANTS This multicenter retrospective cohort study examined 10 649 adult recipients of a primary transplant performed at 26 centers across the United States in the Transplant Skin Cancer Network during 1 of 2 calendar years (either 2003 or 2008) identified through the Organ Procurement and Transplantation Network (OPTN) database. Recipients of all organs except intestine were included, and the follow-up periods were 5 and 10 years. MAIN OUTCOMES AND MEASURES Incident skin cancerwas determined through detailed medical record review. Data on predictors were obtained from the OPTN database. The incidence rates for posttransplant skin cancer overall and for SCC, MM, and MCC were calculated per 100 000 person-years. Potential risk factors for posttransplant skin cancer were tested using multivariate Cox regression analysis to yield adjusted hazard ratios (HR). RESULTS Overall, 10 649 organ transplant recipients (mean [SD] age, 51 [12] years; 3873 women [36%] and 6776 men [64%]) contributed 59 923 years of follow-up. The incidence rates for posttransplant skin cancer was 1437 per 100 000 person-years. Specific subtype rates for SCC, MM, and MCC were 812, 75, and 2 per 100 000 person-years, respectively. Statistically significant risk factors for posttransplant skin cancer included pretransplant skin cancer (HR, 4.69; 95% CI, 3.26-6.73), male sex (HR, 1.56; 95% CI, 1.34-1.81), white 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). CONCLUSIONS AND RELEVANCE Posttransplant skin cancer is common, with elevated risk imparted by increased age, white race, male sex, and thoracic organ transplantation. A temporal cohort effect was present. Understanding the risk factors and trends in posttransplant skin cancer is fundamental to targeted screening and prevention in this population.Note
12 month embargo; Published Online: January 11, 2017.ISSN
2168-6068PubMed ID
28097368Version
Final published versionSponsors
American Academy of Dermatology and Galdermaae974a485f413a2113503eed53cd6c53
10.1001/jamadermatol.2016.4920