title: Prevalence of Skin Cancer and Related Skin Tumors in High-Risk Kidney and Liver Transplant Recipients in Queensland, Australia.
abstract: The increased skin cancer incidence in organ transplant recipients is well-known, but the skin cancer burden at any one time is unknown. Our objective was to estimate the period prevalence of untreated skin malignancy and actinic keratoses in high-risk kidney and liver transplant recipients and to assess associated factors. Organ transplant recipients underwent full skin examinations by dermatologically trained physicians. The proportion of examined organ transplant recipients with histopathologically confirmed skin cancer in the 3-month baseline period was estimated. Prevalence ratios with 95% confidence intervals indicated significant associations. Of 495 high-risk organ transplant recipients (average age = 54 years, time immunosuppressed = 8.9 years), 135 (27%) had basal cell carcinoma, squamous cell carcinoma or Bowen's disease (intraepidermal carcinoma) present and confirmed in the baseline period, with respective prevalence proportions of 10%, 11%, and 18% in kidney transplant recipients and 10%, 9%, and 13% in liver transplant recipients. Over 80% had actinic keratosis present, with approximately 30% having 5 or more actinic keratoses. Organ transplant recipients with the highest skin cancer burden were Australian born, were fair skinned (prevalence ratio = 1.61, 95% confidence interval = [1.07, 2.43]), reported past skin cancer (prevalence ratio =3.39, 95% confidence interval = [1.93, 5.95]), and were receiving the most frequent skin checks (prevalence ratio = 1.76, 95% confidence interval = [1.15, 2.70]). In conclusion, high-risk organ transplant recipients carry a substantial measurable skin cancer burden at any given time and require frequent review through easily accessible, specialized services.
authors.affiliation: QIMR Berghofer Medical Research Institute, Population Health, Queensland, Australia.
authors.forename: Michelle R
authors.initials: MR
authors.lastname: Iannacone
authors.affiliation: Dermatology Research Centre, University of Queensland, School of Medicine, Translational Research Institute, Queensland, Australia.
authors.forename: Sudipta
authors.initials: S
authors.lastname: Sinnya
authors.affiliation: School of Public Health, University of Queensland, Queensland, Australia.
authors.forename: Nirmala
authors.initials: N
authors.lastname: Pandeya
authors.affiliation: Department of Nephrology, University of Queensland, Princess Alexandra Hospital, Queensland, Australia.
authors.forename: Nikky
authors.initials: N
authors.lastname: Isbel
authors.affiliation: Department of Nephrology, University of Queensland, Princess Alexandra Hospital, Queensland, Australia.
authors.forename: Scott
authors.initials: S
authors.lastname: Campbell
authors.affiliation: Queensland Liver Transplant Service, University of Queensland, Princess Alexandra Hospital, Queensland, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Fawcett
authors.affiliation: Dermatology Research Centre, University of Queensland, School of Medicine, Translational Research Institute, Queensland, Australia.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Soyer
authors.affiliation: QIMR Berghofer Medical Research Institute, Population Health, Queensland, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Ferguson
authors.affiliation: QIMR Berghofer Medical Research Institute, Population Health, Queensland, Australia.
authors.forename: Marcia
authors.initials: M
authors.lastname: Davis
authors.affiliation: QIMR Berghofer Medical Research Institute, Population Health, Queensland, Australia.
authors.forename: David C
authors.initials: DC
authors.lastname: Whiteman
authors.affiliation: QIMR Berghofer Medical Research Institute, Population Health, Queensland, Australia; Cancer Research UK Manchester Institute and Institute of Inflammation and Repair, University of Manchester, Manchester, UK. Electronic address: Adele.Green@qimrberghofer.edu.au.
authors.forename: Adèle C
authors.initials: AC
authors.lastname: Green
mesh_terms: D000328:Adult; D000368:Aged; D001913:Bowen's Disease / Q000453:epidemiology; D002280:Basal Cell Carcinoma / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents; D015994:Incidence; D015603:Keratinocytes / Q000166:cytology; D055623:Keratosis, Actinic / Q000453:epidemiology; D016030:Kidney Transplantation; D017093:Liver Failure / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011793:Queensland; D012044:Regression Analysis; D051437:Renal Insufficiency / Q000601:surgery*; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D066027:Transplant Recipients
chemical_list: D007166:Immunosuppressive Agents