Nonmelanoma skin cancer in solid organ transplant recipients: update on epidemiology, risk factors, and management

Dermatol Surg. 2012 Oct;38(10):1622-30. doi: 10.1111/j.1524-4725.2012.02520.x. Epub 2012 Jul 17.

Abstract

Background: Nonmelanoma skin cancers (NMSC) are the most frequently observed cancers in solid organ transplant recipients (SOTR) and may have a significant disease burden.

Objective: To provide an update regarding the epidemiology and management of NMSC in SOTR.

Results: Ten-year incidence rates range from 10% in Italy to 20% in Northern Europe to 70% in Australia. More than 50% of NMSC are located on sun-exposed areas (head, dorsum of hands). Many risk factors have been identified, including age at transplantation, fair skin, type of immunosuppressive drugs, cumulative sun exposure, viral infections, and various genetic markers. Patients with a first NMSC have a 49 times higher risk of developing a subsequent NMSC. Skin self-examination and photoprotection should be encouraged in all transplanted patients. Long-term skin surveillance, early diagnosis and aggressive treatment of any suspicious lesion, reduction of immunosuppressive therapy, and conversion to m-TOR inhibitors can be also effective measures for reduction of NMSC incidence.

Conclusions: NMSC is the most frequent cancer observed in SOTR. Early diagnosis, patient education, and modification of immunosuppression are effective measures for reduction of NMSC incidence.

Publication types

  • Review

MeSH terms

  • Carcinoma, Basal Cell / epidemiology
  • Carcinoma, Basal Cell / etiology*
  • Carcinoma, Basal Cell / prevention & control
  • Carcinoma, Squamous Cell / epidemiology
  • Carcinoma, Squamous Cell / etiology*
  • Carcinoma, Squamous Cell / prevention & control
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Keratosis, Actinic / drug therapy
  • Keratosis, Actinic / epidemiology
  • Organ Transplantation / adverse effects*
  • Patient Education as Topic
  • Population Surveillance
  • Risk Factors
  • Skin Neoplasms / epidemiology
  • Skin Neoplasms / etiology*
  • Skin Neoplasms / prevention & control

Substances

  • Immunosuppressive Agents