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Declining Risk of Skin Cancer After Organ Transplantation
Is the high risk of cutaneous squamous cell carcinoma after organ transplantation declining? A recent study looked at the temporal trends for the risk of skin cancer – particularly squamous cell carcinoma – after organ transplantation.
The high risk of skin cancer after organ transplantation is a major, well-documented clinical challenge, but there are few reports on temporal trends in the risk of post-transplant cutaneous squamous cell carcinoma.
A population-based study published in JAMA Dermatology looked at over 8,000 patients who received a kidney, heart, lung or liver transplant in Norway from 1968 to 2012. Of these, 5,224 were men and 2,802 were women, with an average age at transplantation of 48.5 years.
Nearly 52 percent of these patients developed squamous cell carcinoma, 2.4 percent developed melanoma, and nearly 55 percent developed Kaposi sarcoma.
A decline in the incident rate of squamous cell carcinoma was found over time. Patients who underwent transplantation in the 1983-1987 period had twice the incidence of squamous cell carcinoma than patients who underwent transplantation between 1988 and 2012.
The study concluded that the risk of squamous cell carcinoma in kidney, heart, lung and liver transplant recipients in Norway from 1968 to 2012 peaked in patients who underwent transplantation from 1983 to 1987 and declined significantly thereafter. This could be because less aggressive and more individualised immunosuppressive treatments are available.
The study’s authors warned that the risk of squamous cell carcinoma in organ transplant recipients remains much higher than in the general population and should still be of continuous for dermatologists, physicians, and patients. Close medical and dermatological follow-up of transplant recipients remains essential.
Rizvi SMH, Aagnes B, Holdaas H, Gude E, Boberg KM, Bjørtuft Ø, Helsing P, Leivestad T, Møller B, Gjersvik P. Long-term Change in the Risk of Skin Cancer After Organ Transplantation: A Population-Based Nationwide Cohort Study. JAMA Dermatology. 2017;153(12):1270–1277. doi:10.1001/jamadermatol.2017.2984
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