Skin Cancer Incidence in Patients Receiving Multiple Kidney Transplants
Posted: Monday, February 25, 2019
Patients with periods of transplant allograft failure seem to be associated with having a reduced risk of non-melanoma skin cancer, according to a study by Donal J. Sexton, MD, PhD, of Beaumont Hospital, Dublin, and colleagues. The findings, published in JAMA Dermatology, also show that people who subsequently receive a transplant may then associated with an increased risk.
“These findings may help physicians in counseling transplant recipients about the risks of skin cancer,” the investigators noted. “And [they] also serve as a reminder that cancer surveillance should continue during periods of graft failure.”
The investigators performed a retrospective analysis of data from the records of 3,821 donor kidney transplant recipients. They used information from the National Kidney Transplant Service database and the Irish Cancer Registry from 1994 to 2014. A total of 2,399 patients (62.8%) were male and 1,422 patients (37.2%) were female. The mean age at the time of first data recorded was 41.9 years.
Functioning transplant treatment periods were related to a higher incidence of non-melanoma skin cancer diagnosis compared with periods of graft failure. The adjusted incidence rate ratio was 2.19 (95% confidence interval = 1.56–3.07, P < .001). The adjusted incidence rate ratio of non-melanoma skin cancer started at 41.7 (95% confidence interval = 39.38–44.15) per 1,000 patient-years for the first transplant; it then dropped to 19.29 (95% confidence interval = 13.41–27.76) for the dialysis period after the first allograft failure.
“While ascertainment bias may have contributed to the observed trends, the stagnant incidence of invasive cancer overall highlights the need for continued cancer surveillance during graft failure,” scientists concluded.
Disclosure: The study authors reported no conflicts of interest.