Yearly Burden of Skin Cancer in Non-Caucasian and Caucasian Solid-organ Transplant Recipients

Abstract

Objective: To examine the skin cancer tumor accrual rates in non-Caucasian and Caucasian post-transplant recipients.

Design/setting/participants: Retrospective chart review of solid-organ transplant patients who presented to the outpatient dermatology clinic at the University of Chicago and have had at least one skin biopsy to rule in/out skin cancer in the 10-year period from January 1, 2003, to December 31, 2012. One hundred fifty-two solid-organ transplant recipients were identified through a natural language search in CoPathPlus.

Measurements: Each transplant patient's skin cancer accrual rates, defined as the number of skin cancers per person per year, were examined. The average accrual rates for non-Caucasians and Caucasians were compared and analyzed.

Results: Of the 152 post-transplant patients identified, 58 were non-Caucasian and 94 were Caucasian. Eight (13.8%) non-Caucasians developed skin cancer, compared to 61 (64.9%) Caucasians (P< 0.001). Non-Caucasian post-transplant patients had lower skin cancer accrual rates with an overall skin cancer accrual rate of 0.13, squamous cell carcinoma accrual rate of 0.10, and basal cell carcinoma accrual rate of 0.01 versus 1.13 (P< 0.001), 0.96 (P< 0.001), and 0.15 (P< 0.001), respectively, for Caucasian patients. Comparison of post-transplant non-Caucasian and Caucasian patients who developed skin cancer revealed lower overall (0.96 vs. 1.74; P=0.25), squamous cell carcinoma (0.75 vs. 1.49; P=0.16), and basal cell carcinoma (0.06 vs. 0.24; P=0.13) accrual rates in non-Caucasians.

Conclusion: The authors' findings highlight the importance of annual total body skin exams for post-transplant patients and the need to identify and further educate those transplant patients with a higher risk for skin cancer development.