‘Diligent’ Dermatology Care Needed in Organ-Transplant Recipients

NEW YORK (Reuters Health) – Organ transplant recipients (OTRs) face an increased risk for developing multiple skin cancers, “highlighting the importance of diligent dermatology follow-up,” researchers write in JAMA Dermatology.

There are limited reports on the risks of multiple primary skin cancers in organ-transplant population.

To investigate, Dr. Mackenzie Wehner of University of Texas MD Anderson Cancer Center in Houston and colleagues did a retrospective cohort study using the Optum electronic health record (EHR) database and the Truven Health MarketScan database.

Among 7,390 OTRs in the Optum database and 133,651 in the Truven database, 4.5% and 13.3%, respectively, had evidence of at least one skin cancer treatment.

Two years after the initial posttransplant skin cancer, OTRs had a 44.0% to 57.0% risk of a subsequent skin cancer treatment and a 3.7% to 6.6% risk of having 10 or more skin cancer treatments.

In this retrospective cohort study, roughly half of OTRs who developed at least one skin cancer after their transplant developed another skin cancer within two years, and roughly one in 20 developed 10 or more skin cancers, Dr. Wehner and colleagues note in their paper.

“We are likely underestimating the number of skin cancer treatments by requiring unique treatment codes or, in the case of duplicate treatment codes, unique repair codes. We chose this strategy to prevent overestimation,” they say.

“Statistically significant risk factors for any skin cancer included age, history of skin cancer, and history of actinic keratosis in both data sets, and male sex and thoracic transplant in MarketScan,” they report.

“Identifying OTRs at highest risk for multiple primary skin cancers may help target strategies for prevention and early detection,” they conclude.

“More research is needed on how to earlier identify those OTRs who will go on to get many skin cancers to target strategies for prevention and early detection,” they add.

The study had no commercial funding.

SOURCE: https://bit.ly/3E0Jk2O JAMA Dermatology, online October 20, 2021.

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