Abstract

BACKGROUND: Lung transplant recipients are at high risk of skin cancer but precise annual incidence rates of treated skin cancers per patient are unknown. OBJECTIVES: To prospectively assess the total burden of histologically confirmed squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) and associated factors in lung transplant recipients. METHODS: A population-based cohort of 125 Queensland lung transplant recipients aged 18 years and over, recruited 2013 - 2015, were followed to the end of 2016. All underwent dermatologic skin examinations at baseline and annually thereafter and patients self-reported all interim treated skin cancers which were verified against pathology databases. Standard skin cancer risk factors were obtained via questionnaire, and medications from hospital records. RESULTS: During a median follow-up time of 1.7 years, 29 (23%) and 30 (24%) lung transplant recipients with median duration of immunosuppression 3.3 years, developed SCC and BCC respectively. General population age-standardized incidence rates of SCC and BCC were 201 and 171 per 1000 person-years respectively (based on first primary SCC or BCC during follow-up), but on accounting for multiple primary tumours, corresponding incidence rates were 447 and 281 per 1000 person-years. Risk of multiple SCCs increased around 6-fold in those aged 60+ and in those with previous skin cancer and increased around 3-fold in those treated with the antifungal voriconazole. Multiple BCC risk rose 3-fold from age 60 years and 10-fold with previous skin cancer. CONCLUSIONS: Lung transplant recipients have very high incidence of multiple primary skin cancers. Close surveillance and assiduous prevention measures are essential.

Authors	Way, M; Marquart, L; Chambers, D C; Hopkins, P; Miura, K; Jiyad, Z; Plasmeijer, E I; Ferguson, L E; Davis, M; Whiteman, D C; Soyer, H P; O'Rourke, P; Green, A C
Journal	BRITISH JOURNAL OF DERMATOLOGY
Pages
Volume
Date	1/12/2019
Grant ID	552429
Funding Body	National Health and Medical Research Council (NHMRC) of Australia
URL	http://www.ncbi.nlm.nih.gov/pubmed/?term=10.1111/bjd.18812
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