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Risk factors identified for skin cancer mortality after organ transplant

Older patients, male patients and thoracic transplant recipients were at increased risk for mortality from skin cancer following organ transplantation, according to recently published study results.

Researchers used the Organ Procurement and Transplantation Network Standard Transplant Analysis and Research file to identify all U.S. organ transplant recipients between 1987 and 2013. They calculated the overall population and patient subgroup mortality and hazard ratios.

There were 595,356 transplantation episodes, with 496,951 adults receiving a solid-organ transplant during the study period. Median follow-up was 4.5 years. The majority of transplant recipients were male (62.3%), white (65.2%), between 50 and 59 years of age (29.7%) and kidney recipients (60.8%).

The overall mortality rate in the cohort was 5,308 per 100,000 person-years. The skin cancer–specific mortality rate was 35.26 per 100,000 person-years, according to the researchers.

“The mortality of skin cancer in our cohort is nearly nine times higher than that reported by the Centers for Disease Control and Prevention for the general population (4/100,000 person-years),” the researchers wrote.

Thoracic versus abdominal transplantation (HR = 2.9; 95% CI, 2.52-3.34), age older than 50 years (HR = 2.86; 95% CI, 2.43-3.38), white race (HR = 6.29; 95% CI, 4.63-8.53) and male sex (HR = 1.85; 95% CI, 1.57-2.19) were risk factors associated with skin cancer mortality.

The highest mortality rates were for malignant melanoma (11.48 per 100,000 person-years), squamous cell carcinoma (4.94 per 100,000 person-years) and Merkel cell carcinoma (4.59 per 100,000 person-years).

“This study defines the mortality from skin cancer after organ transplantation and identifies several important risk factors for skin cancer mortality in [organ transplant recipients], mainly male sex, age older than 50 years, thoracic organ transplantation and white race,” the researchers concluded. “In addition, a longer time period since transplantation was associated with an increased likelihood of dying from skin cancer. Future studies should target the role of screening and management strategies in reducing mortality from skin cancer after transplantation.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.