Skin cancer rates soar in people who have transplants

16th January 2017

A person's risk of skin cancer appears to soar after getting a heart or lung transplant, a large study has suggested.

So doctors should refer people who have solid organ transplant for regular skin cancer screening by a dermatologist, suggests Dr Eric Engels from the National Cancer Institute in America.

Patients should also ensure they use sun protection, including avoiding long periods in bright sunlight, wearing protective clothing, and using sunscreen, he said.

Skin cancer occurred at a rate of 1,408 per 100,000 person-years after transplant, with some cancers more common than others, said the study published online in the Journal of the American Medical Association Dermatology.

Researcher Dr Sarah Arron, from the University of California in San Francisco, said: “The skin cancer incidence rate in organ transplant recipients is nearly five times the rate of all cancers combined in the overall US population (448.7 per 100,000).”

Dr Arron's group used the US Organ Procurement and Transplantation Network (OTPN) database to find information on adult recipients of a primary transplant performed in 2003 or 2008. More than 10,600 cases involving solid organ transplants, excluding intestinal transplants, were included.

Predictors of post-transplant skin cancer included a pre-transplant skin cancer and a heart or lung transplant.

Dr Jayan Parameshwar, consultant cardiologist at Papworth Hospital in the UK, said: "Skin cancer is the most common malignancy after heart transplantation."

He said that the suppression of the immune system needed after transplant increases the  effect of sun damage to the skin.

"Using adequate protection with appropriate clothing and sun cream is very important in minimising the risk of skin cancer," he added.

"The main limitation of this study was the imperfect capture of outcome data," said the researchers.

 "The primary reason for missing skin cancer data was the failure to have a dermatologic history noted in the medical record. This may occur if patients were followed by dermatologists in the community and did not report their skin cancers to the transplant team."

The study was funded by the American Academy of Dermatology and Galderma.

For more details, see here