Skin cancer multiplicity in lung transplant recipients: prospective, population-based study
Green, Adèle C
AffiliationPopulation Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
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AbstractBACKGROUND: Lung transplant recipients are at high risk of skin cancer but precise annual incidence rates of treated skin cancers per patient are unknown. OBJECTIVES: To prospectively assess the total burden of histologically confirmed squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) and associated factors in lung transplant recipients. METHODS: A population-based cohort of 125 Queensland lung transplant recipients aged 18 years and over, recruited 2013 - 2015, were followed to the end of 2016. All underwent dermatologic skin examinations at baseline and annually thereafter and patients self-reported all interim treated skin cancers which were verified against pathology databases. Standard skin cancer risk factors were obtained via questionnaire, and medications from hospital records. RESULTS: During a median follow-up time of 1.7 years, 29 (23%) and 30 (24%) lung transplant recipients with median duration of immunosuppression 3.3 years, developed SCC and BCC respectively. General population age-standardized incidence rates of SCC and BCC were 201 and 171 per 1000 person-years respectively (based on first primary SCC or BCC during follow-up), but on accounting for multiple primary tumours, corresponding incidence rates were 447 and 281 per 1000 person-years. Risk of multiple SCCs increased around 6-fold in those aged 60+ and in those with previous skin cancer and increased around 3-fold in those treated with the antifungal voriconazole. Multiple BCC risk rose 3-fold from age 60 years and 10-fold with previous skin cancer. CONCLUSIONS: Lung transplant recipients have very high incidence of multiple primary skin cancers. Close surveillance and assiduous prevention measures are essential.
CitationWay M, Marquart L, Chambers DC, Hopkins P, Miura K, Jiyad Z, et al. Skin cancer multiplicity in lung transplant recipients: prospective, population-based study. Br J Dermatol. 2019.
JournalBritish Journal of Dermatology