Incidence and risk factors for skin cancer following lung transplantation

• Published in: Journal of the American Academy of Dermatology 2015-01, Vol.72 (1), p.92-98
• Main Authors: Rashtak, Shadi, MD, Dierkhising, Ross A., MS, Kremers, Walter K., PhD, Peters, Steve G., MD, Cassivi, Stephen D., MD, MSc, Otley, Clark C., MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; basal cell carcinoma; Carcinoma, Basal Cell - epidemiology; Carcinoma, Basal Cell - pathology; Carcinoma, Squamous Cell - epidemiology; Carcinoma, Squamous Cell - pathology; Dermatology; Female; Humans; immunosuppression; Incidence; Lung Transplantation; Male; Middle Aged; Postoperative Complications - epidemiology; Postoperative Complications - pathology; Retrospective Studies; Risk Factors; skin cancer; Skin Neoplasms - epidemiology; Skin Neoplasms - pathology; solid-organ transplantation; squamous cell carcinoma; Tumor Burden; Young Adult
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2014.09.010

Background Relative to other solid-organ transplantations, limited studies characterize skin cancer among lung-transplant recipients. Objective We sought to assess the cumulative incidence, tumor burden, and risk factors for skin cancer among patients with lung transplantation. Methods Medical records of patients at Mayo Clinic who had undergone lung transplantation between 1990 and 2011 were reviewed (N = 166). Results At 5 and 10 years posttransplantation the cumulative incidence was 31% and 47% for any skin cancer, 28% and 42% for squamous cell carcinoma, 12% and 21% for basal cell carcinoma, and 53% and 86% for death, respectively. Four patients died of metastatic squamous cell carcinoma. The cumulative incidence for a subsequent skin cancer of the same type 4 years after an initial skin cancer was 85% and 43% for squamous and basal cell carcinoma, respectively. Increasing age, male gender, skin cancer history, and more recent year of transplantation were associated with increased risk of skin cancer posttransplantation. Sirolimus was not associated with decreased risk, nor did voriconazole show an increased risk for skin cancer. Limitations Retrospective and tertiary single-center design of the study is a limitation. Conclusions Skin cancers frequently occur in lung-transplant recipients. The risk of subsequent skin cancer is increased substantially in patients who develop a skin cancer after their transplantation.