期刊
EUROPEAN JOURNAL OF DERMATOLOGY
卷 31, 期 6, 页码 712-721出版社
JOHN LIBBEY EUROTEXT LTD
DOI: 10.1684/ejd.2021.4108
关键词
skin cancer; immunosuppression; transplant; oncology
类别
资金
- Royal College of Surgeons of England
- Medical Research Council
- British Association of Plastic, Reconstructive and Aesthetic Surgeons
- Welsh Clinical Academic Training(WCAT) Fellowship
- Health Data Research UK [HDR-9006]
- UK Medical Research Council
- Engineering and Physical Sciences Research Council
- Economic and Social Research Council
- Department of Health and Social Care (England)
- Chief Scientist Office of the Scottish Government Health and Social Care Directorates
- Public Health Agency (Northern Ireland),
- British Heart Foundation (BHF)
- Wellcome Trust
- Health and Social Care Research and Development Division (Welsh Government)
- Swansea Bay University Health Board
- AAPS/EURAPS Academic Scholarship
This study found a higher incidence of skin cancer in solid organ transplant recipients, with age, male gender, and azathioprine use being associated with increased risk. Contemporary immunomodulators such as tacrolimus and mycophenolate were found to reduce skin cancer risk when compared to older medications like cyclosporin and azathioprine. Different organ transplant recipients had varying levels of risk for skin cancer.
Background: Skin cancer is more common in transplant recipients, although the quoted incidence is variable. Objectives: This study investigated the incidence of skin cancer in solid organ transplant recipients (OTRs) in a national cohort and the effect of pharmacotherapeutic agents Materials & Methods: Transplant patients were identified from Patient Episode Database for Wales (PEDW) using Office of Population Census and Surveys Classifications of Interventions and Procedures-4 (OPCS-4) codes. Controls were matched to cases according to age, sex and socioeconomic status. Skin cancer data were obtained from linkage with other national data sources. Incidence was calculated per 100,000 person-years at risk (PYAR). Negative binomial regression was used to calculate adjusted incidence rate ratios (IRRs) for each organ type. Results: During 2000-2018, 2,852 Welsh patients underwent solid organ transplantation. A total of 13,527 controls were matched from the general population. The incidence of skin cancer within the OTR cohort was 1203.2 per 100,000 PYAR vs 133.9 in the matched control group. Age, male gender and azathioprine use were all associated with an increased risk of skin cancer. Contemporary immunomodulators such as tacrolimus and mycophenolate were associated with a reduction in skin cancer risk when compared to their predecessors, cyclosporin and azathioprine. The highest adjusted IRR was observed in heart transplant recipients (IRR: 10.82; 95% CI: 3.64-32.19) and the lowest in liver transplant recipients (IRR: 2.86; 95% CI: 1.15-7.13). Conclusion: This study highlights the need for long-term routine skin cancer surveillance for all OTRs and the importance of using contemporary immunomodulators, when possible, for risk reduction.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据