title: Surveillance of nonmelanoma skin cancer incidence rates in kidney transplant recipients in Ireland.
abstract: BACKGROUND
  The incidence of nonmelanomatous skin cancer (NMSC) is substantially higher among renal transplant recipients (RTRs) than in the general population. With a growing RTR population, a robust method for monitoring skin cancer rates in this population is required.
  
  
  METHODS
  A modeling approach was used to estimate the trends in NMSC rates that adjusted for changes in the RTR population (sex and age), calendar time, the duration of posttransplant follow-up, and background population NMSC incidence rates. RTR databases in both Northern Ireland (NI) and the Republic of Ireland (ROI) were linked to their respective cancer registries for diagnosis of NMSC, mainly squamous cell carcinoma (SCC) and basal cell carcinoma (BCC).
  
  
  RESULTS
  RTRs in the ROI had three times the incidence (P<0.001) of NMSC compared with NI. There was a decline (P<0.001) in NMSC 10-year cumulative incidence rate in RTRs over the period 1994-2009, which was driven by reductions in both SCC and BCC incidence rates. Nevertheless, there was an increase in the incidence of NMSC with time since transplantation. The observed graft survival was higher in ROI than NI (P<0.05) from 1994-2004. The overall patient survival of RTRs was similar in NI and ROI.
  
  
  CONCLUSIONS
  Appropriate modeling of incidence trends in NMSC among RTRs is a valuable surveillance exercise for assessing the impact of change in clinical practices over time on the incidence rates of skin cancer in RTRs. It can form the basis of further research into unexplained regional variations in NMSC incidence.
authors.affiliation: 1 Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, UK. 2 Nephrology Research, Centre for Public Health, Queen's University Belfast, UK. 3 Department of Nephrology, Beaumont Hospital, Dublin, Ireland. 4 Royal College of Surgeons in Ireland, Dublin, Ireland. 5 National Cancer Registry of Ireland, Cork, Ireland. 6 Address correspondence to: Finian J. Bannon, M.A., Ph.D., Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Mulhouse Building, Grosvenor Road, Belfast, BT12 6BJ, Northern Ireland.
authors.forename: Finian J
authors.initials: FJ
authors.lastname: Bannon
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: McCaughan
authors.forename: Carol
authors.initials: C
authors.lastname: Traynor
authors.forename: Katie
authors.initials: K
authors.lastname: O'Brien
authors.forename: Anna T
authors.initials: AT
authors.lastname: Gavin
authors.forename: Alexander P
authors.initials: AP
authors.lastname: Maxwell
authors.forename: Harry
authors.initials: H
authors.lastname: Comber
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Conlon
mesh_terms: D000328:Adult; D002280:Basal Cell Carcinoma / Q000150:complications / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000453:epidemiology; D016208:Databases, Factual; D062665:Epidemiological Monitoring; D005260:Female; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D007494:Ireland / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D012042:Registries; D012878:Skin Neoplasms / Q000150:complications* / Q000453:epidemiology*; D066027:Transplant Recipients; D016896:Treatment Outcome