Skin cancer in kidney and heart transplant recipients and different long-term immunosuppressive therapy regimens

Background: Nonmelanoma skin cancer occurs frequently in organ transplant recipients, but the relative importance of different immunosuppressive therapy regimens is unclear. Objective: We studied the risk of skin cancer in the complete, single-center Norwegian cohort of kidney and heart transplant r...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology 1999-02, Vol.40 (2), p.177-186
Main Authors: Jensen, Petter, Hansen, Svein, Møller, Bjørn, Leivestad, Torbjørn, Pfeffer, Per, Geiran, Odd, Fauchald, Per, Simonsen, Svein
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Biological and medical sciences
Carcinoma, Squamous Cell - etiology
Child
Child, Preschool
Cohort Studies
Dermatology
Female
Heart Transplantation
Humans
Immunosuppressive Agents - adverse effects
Infant
Kidney Transplantation
Male
Medical sciences
Melanoma - etiology
Middle Aged
Multivariate Analysis
Risk Factors
Sarcoma, Kaposi - etiology
Skin Neoplasms - etiology
Tumors of the skin and soft tissue. Premalignant lesions
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Summary:Background: Nonmelanoma skin cancer occurs frequently in organ transplant recipients, but the relative importance of different immunosuppressive therapy regimens is unclear. Objective: We studied the risk of skin cancer in the complete, single-center Norwegian cohort of kidney and heart transplant recipients (n = 2561). Methods: We determined cancer risk estimation by means of standardized incidence ratios and multivariate Cox regression. Results: Transplant recipients had an increased risk of cutaneous squamous cell carcinoma (SCC) (65-fold), malignant melanoma (3-fold), and Kaposi’s sarcoma (84-fold), and of lip SCC (20-fold), compared with the general population. After adjustment for age, kidney transplant recipients receiving cyclosporine, azathioprine, and prednisolone had a significantly (2.8 times) higher risk of cutaneous SCC relative to those receiving azathioprine and prednisolone. After adjustment for age and type of immunosuppressive regimen, heart transplant recipients had a significantly (2.9 times) higher risk than kidney transplant recipients. Conclusion: The risk of cutaneous SCC, malignant melanoma, Kaposi’s sarcoma, and lip SCC is increased in kidney and heart transplant recipients. The risk of posttransplant cutaneous SCC is related to the degree of immunosuppression caused by long-term immunosuppressive therapy. (J Am Acad Dermatol 1999;40:177-86.)
ISSN:0190-9622
1097-6787
DOI:10.1016/S0190-9622(99)70185-4