ORIGINAL ARTICLE   Free access

Giornale Italiano di Dermatologia e Venereologia 2020 October;155(5):669-75

DOI: 10.23736/S0392-0488.18.06099-6

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Behavioral and demographic factors associated with occurrence of non-melanoma skin cancer in organ transplant recipients

Luca FANIA ^{1, 2}, Damiano ABENI ² ✉, Ilaria ESPOSITO ¹, Gionata SPAGNOLETTI ³, Franco CITTERIO ³, Jacopo ROMAGNOLI ³, Marina CASTRIOTA ⁴, Francesco RICCI ^{1, 2}, Francesco MORO ¹, Francesca PERINO ¹, Cinzia MAZZANTI ², Clara DE SIMONE ¹, Ketty PERIS ¹

¹ Department of Dermatology, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy; ² Istituto Dermopatico dell’Immacolata (IDI) IRCCS, Rome, Italy; ³ Unit of General Surgery and Organ Transplantation, IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy; ⁴ ASL Lecce, Lecce, Italia

BACKGROUND: Non-melanoma skin cancers (NMSC) are the most common epithelial malignancies in organ transplantation recipients (OTRs). In Italy, incidence rates of post-transplantation NMSC are approximately 5% after 5 years and 10% after 10 years since organ transplantation. The objective was to describe risk factors associated with NMSC in a cohort of renal and liver transplant recipients, in a single-center longitudinal study.
METHODS: Renal and liver transplant patients, who underwent transplantation between June 1985 and December 2015, were visited for the first time or followed-up in a dedicated outpatient clinic every six months until July 2016.
RESULTS: We included 356 renal and 76 liver transplant patients. 108 OTRs (25.6%) presented 299 NMSC. 74 patients developed actinic keratosis (17.1%), 36 patients squamous cell carcinoma (8.5%), and 52 patients basal cell carcinoma (12.3%). Time from transplantation and kidney transplant were the main risk factors for NMSC. Higher incidences of all NMSC were observed in patients >60 years, males and smokers, while decreased incidences were detected in individuals with higher educational levels. Multiple logistic regression models confirmed that male gender (RR 3.3, P=0.001), cigarette smoking (RR 2.0, P=0.026), light eye color (RR 2.9, P=0.001) and family history of cancer (RR 1.8, P=0.042) were independently associated with NMSC.
CONCLUSIONS: Dermatological follow-up is important in OTRs, due to the higher risk of tumors and mainly NMSC. Clinical and environmental factors, including cigarette smoking, are useful in characterizing OTR with higher risk of NMSC.

KEY WORDS: Skin neoplasms; Organ transplantation; Keratosis, actinic; Carcinoma, basal cell; Carcinoma, squamous cell