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Fitzpatrick skin type independently predicted SCC risk in organ transplant recipients

Fitzpatrick skin type was an independent risk factor for squamous cell carcinoma development in solid organ transplant recipients, according to study results.

Researchers evaluated 694 solid organ transplant recipients (OTR; mean age at transplantation, 46.9 years; 64.7% men) who completed questionnaires on demographics, transplant type, Fitzpatrick skin type (FST) and history of skin cancer. Risk factors for developing squamous cell carcinoma (SCC) after transplantation were determined through univariate and multivariate analyses.

Six hundred thirty-nine (92.1%) of the patients identified themselves as white, and all six FSTs were represented by study patients. Skin cancer history was obtained for 556 patients, and included 317 (57%) with a history of SCC.

Men had a 1.3-fold increased risk for SCC compared with women (HR=1.33; 95% CI, 1.04-1.71). Patients aged 50 years and older at transplantation also were more likely to develop SCC compared with patients younger than 50 years (HR=4.34; 95% CI, 3.23-5.83).

With each incremental decrease from FST VI to FST I, risk for SCC increased (P<.001 for trend).

“Subjects with type I skin had a 1.7-fold increased risk for SCC over those with type IV skin (HR=1.67; 95% CI, 1.07-2.62) and a 3.5-fold increased risk over those with type VI skin (HR=3.47; 95% CI, 1.46-8.28),” the researchers reported.

“FST, age at time of transplantation and male sex are independent risk factors for the development of SCC in the post-transplantation population,” the researchers concluded. “FST … should be elicited from patients who have gone or will undergo organ transplantation.

“Until a clinical predictive model is validated in a prospective study, male OTR patients who receive a transplantation at or after age 50 years, and those with a burning or tanning history consistent with FST I, II or III should receive significant education and aggressive surveillance for the development of skin cancers.”