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Post-transplant squamous cell carcinoma incidence declined in recent years

There has been a consistent decline in squamous cell carcinoma post-transplant among organ transplant recipients in Norway since the 1980s, according to recent findings.

The population-based, nationwide, prospective cohort study included 8,026 patients who underwent a solid organ transplant after late-stage organ failure from 1968 to 2012. Eligible participants had received a kidney, heart, lung or liver transplant, and were subsequently treated with immunosuppressive therapy.

Squamous cell carcinoma, melanoma and Kaposi’s sarcoma incidence in the skin was the primary outcome measure. The investigators followed patients for a median of 6.7 years per recipient, for a total of 69,590 person-years of follow-up.

The overall standardized incidence ratio for squamous cell carcinoma was 51.9 (95% CI, 48.4-55.5), according to the findings. For melanoma, the ratio was 2.4 (95% CI, 1.9-3), and the ratio for Kaposi’s sarcoma was 54.9 (95% CI, 27.4-98.2).

Among patients receiving solid organ transplants from 1983 to 1987, the squamous cell carcinoma standardized incidence ratio was 102.7 (95% CI,85.8-122.1). This ratio decreased to 21.6 (95% CI, 16.8-27) during the span between 2003 and 2007.

In an adjusted analysis accounting for factors ranging from follow-up times and population risks along with age, transplanted organ, and sex, the standardized incidence ratio peaked in the 1983-1987 period then decreased to 0.42 (95% CI, 0.32-0.55) for 1998-2002, to 0.31 (95% CI, 0.22-0.42) for 2003-2007, and to 0.44 (95% CI, 0.30-0.66) for 2008-2012.

“The risk of [squamous cell carcinoma] after organ transplantation has declined significantly since the mid-1980s in Norway,” the researchers concluded. “Less aggressive and more individualized immunosuppressive treatment and close clinical follow-up may explain the decline. Still, the risk of [squamous cell carcinoma] in organ transplant recipients remains much higher than in the general population and should be of continuous concern for dermatologists, transplant physicians, and patients.” – by Rob Volansky

Disclosure: The researchers report no relevant financial disclosures.