NEW YORK – Recipients of pancreas transplants had a 19.6% cumulative incidence of developing skin cancer 10 years after transplant.
Moreover, those patients who developed squamous cell carcinoma (SCC) following transplant were found to have a 56% likelihood of developing a second SCC within 2 years, while patients who developed basal cell carcinoma (BCC) had a 36% chance of recurrence at 2 years.
The data, presented in a poster at the annual meeting of the American College of Mohs Surgery, show that “intensive educational and preventative strategies should be targeted at the pancreas transplant population,” according to Dr. Joshua Spanogle, a resident in the department of dermatology at the Mayo Clinic in Rochester, Minnesota.
Dr. Spanogle and his colleagues looked at 216 pancreas transplant recipients seen at a tertiary care center between 1996 and 2007. About half of the subjects were male, and the average age was 43 years, with a range of 21-71 years.
Overall, 107 patients received their pancreas transplant following a prior kidney transplant and were referred to as the “pancreas after kidney” group. A total of 67 patients received a pancreas transplant and did not receive a new kidney, and were known as the “pancreas transplant alone” group. Forty-two patients were in the “simultaneous pancreas-kidney” transplant group.
For all transplant recipients, the cumulative incidence of developing any skin cancer was 4.7% by 2 years. The cumulative incidence rose to 12.7% by 5 years and 19.6% by 10 years post transplant, Dr. Spanogle reported.
Looking at SCC specifically, the cumulative incidence was 2.8% at 2 years, 10.3% at 5 years, and 16.7% at 10 years. For BCC, the cumulative incidence rates were 2.4%, 7.8%, and 17.4% at 2, 5, and 10 years, respectively, he wrote.
Once patients were found to have an SCC, however, the chance of developing a second SCC within 2 years rose: There was a 56% cumulative incidence of subsequent SCC in that population. The risk for a second BCC after an initial post-transplant BCC diagnosis was also high, though less dramatic: The cumulative incidence for BCCs in the post-transplant, post-BCC-diagnosis population was 36%.
“None of the following variables were associated with an increased risk of skin cancer: type of transplant, induction therapy, initial immunosuppressive regimen, rejection status, or sex,” he pointed out. Only age was a significant predictor of the development of skin cancer, with a hazard ratio of 1.05.
Dr. Spanogle stated that he had no conflicts of interest to disclose.