Risk-Guided Screening Enhances Early Skin Cancer ID in Transplant Cohort

KEY TAKEAWAYS

• Solid organ transplant (SOT) recipients were almost 8 times more likely to develop skin cancer posttransplant compared to nonrecipients.

• KP-SUNTRAC improved screening and detection rates, particularly in high- and very high−risk groups.

• Enhanced surveillance did not increase short-term health care utilization.

A risk-based skin cancer surveillance strategy was associated with improved early detection rates among solid organ transplant (SOT) recipients, according to findings from a recent retrospective cohort analysis of the implementation of the KP-SUNTRAC program across Kaiser Permanente Northern California (KPNC).

The study authors analyzed data from 2,083 adult SOT recipients matched 1:20 with nonrecipients by sex, race and ethnicity, and care facility, with follow-up through early 2024. Researchers compared baseline skin cancer screening and detection rates prior to KP-SUNTRAC (2016 to 2021), with outcomes after rollout (2022 to 2024).

Overall, SOT recipients saw a 7.8-fold increased risk for post-transplant skin cancer vs. matched nonrecipients (HR = 7.78; 95% CI, 5.97 to 10.10). Following KP-SUNTRAC implementation, incidence of first skin cancer detections increased (HR = 2.57; 95% CI, 1.76 to 3.73), with significant gains in the high-risk (HR = 1.98; 95% CI, 1.39 to 2.82) and very high−risk (HR = 2.17; 95% CI, 1.21 to 3.86) groups. Increased screening did not correspond with a rise in health care utilization.

"This cohort study found that KP-SUNTRAC was associated with improved skin cancer screening rates and detection among SOT recipients at higher risk of developing skin cancer, without increasing short-term health care utilization," the authors wrote. "This targeted surveillance approach supports timely diagnosis and has the potential to reduce morbidity and future health care costs."

Source:  Lee D, et al. JAMA Dermatology. 2025. doi:10.1001/jamadermatol.2025.3890