Risk factors for non-melanoma skin cancer development in renal transplant recipients: a 40-year retrospective study in Croatia

Bašić‐Jukić, Nikolina; Borlinić, Tajana; Tešanović, Deša; Mokos, Ivica; Lukić, Ivan; Mokoš, Zrinka Bukvić

doi:10.3325/cmj.2022.63.148

Cited by 3 publications

(2 citation statements)

References 30 publications

(49 reference statements)

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“…Our results showed that 23% of patients diagnosed with NMSC were within the first 5 years after transplantation, while 51.3% had been transplanted for over 10 years. Advanced age has been identified in the literature as a risk factor for NMSC development in RTx [19,20]. We found that the average age of RTxs at the time of NMSC diagnosis was significantly higher compared to RTx without this type of cancer, increasing the risk of developing this tumor by more than 5 times, consistent with other research in individuals with the same clinical condition [14,20,21].…”

Section: Discussionsupporting

confidence: 90%

Routine outpatient dermatological evaluation of kidney transplant recipients using dermatoscopy as an additional tool: a preliminary analysis

Caldas,

Abbud-Filho

et al. 2023

Preprint

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Introduction. Non-melanoma skin cancer (NMSC) is the most common malignancy following renal transplantation and leads to significant years of potential life lost. Dermatoscopy use in the routine clinical setting has shown promise in increasing the diagnosis of NMSC. Objectives. 1) To assess the prevalence of NMSC in renal transplant recipients (RTx) using the dermatoscopy (DC); 2) to identify associated risk factors; 3) to compare the accuracy of dermatoscopy with histopathological results. Methods. A prospective study was conducted from January 2022 to January 2023 and 100 RTx from the outpatient clinic were randomly referred for dermatological examination and then divided into two groups: with NMSC (NMSC; n=39) and without NMSC (non-NMSC; n=61). RTx variables related to habits, tumor characteristics, and transplantation were analyzed. Results: Clinical dermatological evaluation identified 23 squamous cell carcinoma (SCC) (59%) and 16 basal cell carcinoma (BCC) (41%). Factors associated with NMSC included: male gender (OR=2); age over 50 years (OR=5.4); occupational sun exposure (OR=2.5); recreational sun exposure (OR=4.9); actinic keratosis (OR=6.5); family history of NMSC (OR=7.6); and induction with thymoglobulin (OR=2.4). The accuracy rate between clinical diagnosis and dermatoscopy compared to the final histological result after biopsy was 81.25% for suspected NMSC cases. Conclusions: NMSC occurred in 39% of the evaluated RTx cases, with a family history and actinic keratosis being the main risk factors. Dermatoscopy diagnosed NMSC in 81%, and therefore, we suggest that this examination should be incorporated into routine evaluation.

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Section: Discussionsupporting

confidence: 90%

Routine outpatient dermatological evaluation of kidney transplant recipients using dermatoscopy as an additional tool: a preliminary analysis

Caldas,

Abbud-Filho

et al. 2023

Preprint

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“…Organ transplant recipients face a significantly higher risk of developing NMSC [ 23 , 24 ]. The incidence of SCC is 250 times higher, and that of BCC is 10 times higher in organ transplant recipients compared to the general population.…”

Section: Discussionmentioning

confidence: 99%

The association between hydrochlorothiazide use and non-melanoma skin cancer in kidney transplant recipients

Rahamimov,

Telem,

Davidovichi

et al. 2024

Clinical Kidney Journal

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Background hydrochlorothiazide (HCTZ) diuretics were correlated with an increased risk of Non-Melanoma Skin Cancer (NMSC) and melanoma in the general population. Information is a scarce regarding this effect in Kidney transplant recipients who are at increased risk of skin malignancies under immunosuppression. Methods Single center retrospective analysis of adult kidney transplant recipients between January 1, 2010, and December 31, 2015. The primary outcome of the study was the first diagnosis of skin cancer that was removed and pathologically analyzed. Exposure to thiazides was defined as HCTZ use daily for at least one year at a dose of 12.5 mg. Results Among 520 kidney transplant recipients, 50 (9.4%) were treated with HCTZ. During a median follow-up of 9.8 years, 67 patients underwent surgical removal and pathological analysis of at least one skin cancer. Exposure to HCTZ during the three years following transplantation was associated with an increased risk of skin cancer (p=0.004). In a multivariate model, there was a significant association between HCTZ exposure and NMSC (HR 2.54, 95%CI 1.26-5.15, p=0.007). There was a higher rate of Basal Cell Carcinoma (BCC) with HCTZ exposure, according to both univariate and multivariate analyses (HR 2.61, 95%CI 1.06-6.43, p=0.037) and (HR 3.03, 95%CI 1.22-7.55, p=0.017, respectively). However, no significant association was observed between HCTZ exposure and Squamous Cell Carcinoma (SCC). Conclusions These findings suggest a benefit of increased frequency of dermatologist inspection in kidney transplant recipients receiving HCTZ especially in increased UV exposure area.

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Recent Changes in the Incidence and Characteristics of Cutaneous Squamous Cell Carcinomas in Finland from 2006 to 2020: A Retrospective Cohort Study

Lounas,

Ylitalo,

Salmi

et al. 2024

Acta Derm Venereol

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Registers recording only 1 tumour per patient do not enable assessment of the real burden of cutaneous squamous cell carcinoma. To investigate recent changes in the incidence and characteristics of tumours, a retrospective 15-year patient cohort study was performed in Finland. Histopathological diagnoses of cutaneous squamous cell carcinomas diagnosed between 2016 and 2020 were obtained from the pathology database and clinical data from patient medical records and combined with previously collected data for the years 2006–2015. Altogether 1,472 patients with 2,056 tumours were identified. The crude incidence increased from 19/100,000 persons in 2006 to 42 in 2020 (p < 0.001), increasing most in people aged over 80 years. The percentage of tumours located on the trunk increased from 5.3% during the first 5-year period, 2006–2010, to 9.0% in 2016–2020. Also, the location of tumours was significantly different between men and women, as men had more tumours on the scalp and ears, and women on the lower limbs. A slight change in the tumours from poorly to well differentiated and a decrease in the invasion depth were noted between 2006 and 2020. As the burden of tumours continues to increase, more attention should be paid to their prevention.

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Risk factors for non-melanoma skin cancer development in renal transplant recipients: a 40-year retrospective study in Croatia

Cited by 3 publications

References 30 publications

Routine outpatient dermatological evaluation of kidney transplant recipients using dermatoscopy as an additional tool: a preliminary analysis

Routine outpatient dermatological evaluation of kidney transplant recipients using dermatoscopy as an additional tool: a preliminary analysis

The association between hydrochlorothiazide use and non-melanoma skin cancer in kidney transplant recipients

Recent Changes in the Incidence and Characteristics of Cutaneous Squamous Cell Carcinomas in Finland from 2006 to 2020: A Retrospective Cohort Study

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