Incidence of and Risk Factors for Skin Cancer in Organ Transplant Recipients in the United States
AuthorGarrett, Giorgia L.
Blanc, Paul D.
Lloyd, Amanda Abramson
Ahmed, Rehana L.
Cheng, Joyce Y.
Colegio, Oscar R
Del Guzzo, Christina A.
Ortiz, Arisa Elena
Golden, Spring K.
Graves, Michael S.
Griffin, John R.
Hopkins, R. Samuel
Huang, Conway C.
Bae, Gordon Hyeonjin
Jennings, Thomas A.
Jiang, Shang I. Brian
Karia, Pritesh S.
Koyfman, Shlomo A.
Leitenberger, Justin J.
Moreau, Jacqueline F.
Nijhawan, Rajiv I.
Olasz, Edit B.
Patel, Parth H.
Patel, Vishal Anil
Prabhu, Arpan V.
Schmults, Chrysalyne D.
Shih, Allen F.
Stein, Jennifer A.
Arron, Sarah T.
AffiliationUniv Arizona, Med Ctr
MetadataShow full item record
PublisherAMER MEDICAL ASSOC
CitationIncidence of and Risk Factors for Skin Cancer in Organ Transplant Recipients in the United States 2017, 153 (3):296 JAMA Dermatology
Rights© 2017, American Medical Association
Collection InformationThis 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 email@example.com.
AbstractIMPORTANCE 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  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.
Note12 month embargo; Published Online: January 11, 2017.
VersionFinal published version
SponsorsAmerican Academy of Dermatology and Galderma
CollectionsUA Faculty Publications
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