Validity of patient skin cancer report among organ transplant recipients

Abstract

Skin cancer is a common, potentially life-threatening malignancy in organ transplant recipients (OTR), and it is important for transplant physicians to be aware of patient history of skin cancer. Patient self-report represents a quick method of obtaining past medical history of skin cancer but no study has validated the self-report of skin cancer among OTR. Among 339 OTR with a history of skin cancer, the sensitivity and specificity of self-report of non-melanoma skin cancer (NMSC) were 1.00 and 0.92, with a correct classification rate of 0.92. Breakdown of NMSC into squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) resulted in a decrease in correct classification, to 0.83 for SCC and 0.74 for BCC. For SCC, sensitivity was 0.81 and specificity was 0.83, while BCC had a sensitivity of 0.52 and specificity of 0.86. Melanoma self-report had a sensitivity of 0.90 and specificity of 0.86, with a correct classification rate of 0.90. Overall, OTR have comparable accuracy of self-report with the general population. Owing to the high prevalence and increased risk of metastatic potential of skin cancer in this population, the ability to distinguish between cancer types is an important consideration in the dermatologic care of OTR.

Comparison of pre‐ and post‐transplant sun‐safe behavior of kidney transplant recipients: What is needed to improve?

“…Patient education is also important for the early recognition of high‐risk SCC. In a report, patients were unable to distinguish skin cancer types . Most likely, this ability could be increased with pictures of skin tumors .…”

Arsenic Trioxide Induces T Cell Apoptosis and Prolongs Islet Allograft Survival in Mice

“…[49][50][51] Also, oncologic disease after transplantation is one of the major causes of death in transplant patients with a functioning graft. 52,53 Existing treatment protocols are lacking to protect the allograft as well as attack the malignancy simultaneously.…”

Fitzpatrick skin phototype is an independent predictor of squamous cell carcinoma risk after solid organ transplantation

“…We have previously described a correct classification rate of 0.83 for self-report of SCC in this cohort. (23) Although our questionnaire did not ask specifically about immunosuppressive medications, organ transplant category was used as a proxy for level of immunosuppression. (6, 24–28) Further studies may examine why no significant difference in risk was seen between the organ transplant categories.…”