Solid organ transplant recipients have increased risk for developing keratinocyte cancers (KC), including cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), in part as a result of immunosuppressive medications administered to prevent graft rejection. In the general population, KC are associated with increased risks of subsequent malignancy, however, the risk in organ transplant populations has not been evaluated. We addressed this question by linking the U.S. Scientific Registry of Transplant Recipients, which includes data on KC occurrence, with 15 state cancer registries. Risk of developing malignancies after KC was assessed among 118,440 Caucasian solid organ transplant recipients using multivariate Cox regression models. Cutaneous SCC occurrence (n=6169) was associated with 1.44-fold increased risk [95% confidence interval (CI): 1.31-1.59] for developing later malignancies. Risks were particularly elevated for non-cutaneous SCC, including those of the oral cavity/pharynx [hazard ratio (HR)=5.60, 95%CI: 4.18-7.50] and lung (HR=1.66, 95%CI: 1.16-2.31). Cutaneous SCC was also associated with increased risk of human papillomavirus-related cancers, including anal cancer (HR=2.77, 95%CI: 1.29-5.96) and female genital cancers (HR=3.43, 95%CI: 1.44-8.19). In contrast, BCC (n=3669) was not associated with overall risk of later malignancy (HR=0.98, 95%CI: 0.87-1.12) including any SCC. Our results suggest that transplant recipients with cutaneous SCC, but not BCC, have an increased risk of developing other SCC. These findings somewhat differ from those for the general population and suggest a shared etiology for cutaneous SCC and other SCC in the setting of immunosuppression. Cutaneous SCC occurrence after transplantation could serve as a marker for elevated malignancy risk.
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 November 2023.
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Altmetric has tracked 34,350,842 research outputs across all sources so far. This one has received more attention than most of these and is in the 67th percentile.
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