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Incidence of Nonmelanoma Skin Cancer in Recipients of Multiple Kidney Transplants

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Key Points

  • Periods of treatment with a functioning transplant were associated with a higher incidence of nonmelanoma skin cancer vs periods of graft failure.
  • The adjusted incidence rate ratios of nonmelanoma skin cancer occurrence were 41.7 per 1,000 patient-years in the first transplant and 19.29 in the dialysis period following the first allograft failure.
  • Incidence rose and fell following each subsequent consecutive transplant.

The incidence of nonmelanoma skin cancer may be more common in recipients of kidney transplants vs patients on maintenance dialysis. Researchers looked to determine if the risk of nonmelanoma skin cancer is lower during periods of graft loss with a return to dialysis vs during periods of functioning grafts in patients who have received more than one kidney transplant. These findings were published by Sexton et al in JAMA Dermatology.

Study Methods

Researchers performed a retrospective analysis of data from 1994 to 2014 from the Irish National Kidney Transplant Service database. Standardized incidence ratios were calculated for nonmelanoma skin cancer incidence in comparison with incidence in the general population.

Data from the records of 3,821 kidney transplant recipients were analyzed—in this population, 3,215 patients had received 1 transplant, 522 had received 2 transplants, and 84 had 3 or more transplants.

The primary outcome measures were incidence rates of nonmelanoma skin cancer per 1,000 patient-years and incident rate ratios after kidney transplant.

Findings

Periods of treatment with a functioning transplant were associated with a higher incidence of nonmelanoma skin cancer vs periods of graft failure. The adjusted incidence rate ratios of nonmelanoma skin cancer occurrence were 41.7 per 1,000 patient-years in the first transplant and 19.29 in the dialysis period following the first allograft failure. The incidence rose and fell following each subsequent consecutive transplant. Other risk factors for nonmelanoma skin cancer from the fully adjusted model included male sex, number of transplants, and patient age.

The study authors concluded, “In recipients of multiple kidney transplants, while the incidence of nonmelanoma skin cancer fell during periods defined by transplant failure, there was residual elevated risk. 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.”

Disclosure: The study authors' full disclosures can be found at jamanetwork.com.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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