Study Reveals Skin Cancer Surveillance Gaps in Transplant Recipients

New research suggests inconsistencies in skin cancer prevention advice given during follow-up for solid organ transplant recipients (SOTRs). 

The study researchers looked at 749 living SOTRs were identified in a target region of the UK, (648 were included for the analysis after exclusions. A total of 15.4% of SOTRs had been diagnosed with skin cancer since transplantation (54 cases of squamous cell carcinoma (SCC), 59 cases of basal cell carcinoma, and 6 cases of melanoma), and 17.2% of SOTRs Regular dermatological follow-up for skin surveillance. There were 26 patients with one lesion and 27 patients with two or more lesions; 10.5% of SOTRs had extensive actinic keratoses.

Older age (P = 0.01), male sex (P = 0.03), and increased duration of immunosuppression (P = 0.03) were all associated with the presence of skin cancer. Mycophenolate mofetil (MMF), tacrolimus, and prednisolone represented the most common immunosuppressant regimen among SOTRs. The use of MMF correlated with SCC burden (P = 0.009). Just 7.3% of SOTRs were prescribed sunscreen, and 3.7% were offered acitretin.

"Our study highlights that there is a lack of consistency with regard to optimal skin cancer prevention follow-up and advice, in a region that does not have a routine dermatological skin surveillance service for SOTRs," the authors wrote in their conclusion. "Limited service resources highlight the importance of collaborative consensus guidelines on best practice for the prevention of skin cancer in SOTRs. Therefore, we have instituted a set of recommendations within our region including guidance regarding prescribed sunscreen use, pathways on how best to access dermatology for SOTRs presenting with skin lesions, and follow-up based on stratification of risk factors."

Source: Gilbert G, et al. British Journal of Dermatology. 2024;191(Supplement_1):i141-i142. Doi:10.1093/bjd/ljae090.297

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