Comparison of skin cancer risk between renal transplant recipients and patients with glomerular diseases in rural Queensland

Abstract

AbstractIntroudctionThere is increased risk of skin cancer in patients with gloermular disease or those with renal transplant.ObjectivesTo compare the risk of skin cancer between kidney recipients (KTRs) and patients with glomerular disease (GD).DesignThe cohort comprised patients with KTRs (n = 61) and GD (n = 51) in Central and Central West Queensland, Australia. A quantitative cohort study was undertaken to study the risk of skin cancer in rural communities between two subgroups of patients with kidney diseases in relationship to immunosuppression. Statistical analyses of the differences in incidence of skin cancers between the two groups were done by chi‐square test, Fisher's exact test, independent t‐test and McNemar's test.FindingsKTRs with non‐melanoma skin carcinoma (NMSC) increased significantly after treatment with immunosuppressants (pre‐transplantation, n = 11 [18.0%], post‐transplantation, n = 28 [45.9%]; p < 0.001). There were no differences in number of patients with NMSC observed in the GD group (pre‐diagnosis, n = 6 [11.8%], post‐diagnosis, n = 7 [13.7%]; p = 1.000). Compared to the risks at 1 year post‐immunosuppressants, the incidence of NMSC of KTRs increased significantly at 3 years (20.3% vs. 35.4%, p < 0.001) and 5 years (20.3% vs. 62.2%, p < 0.001) post‐immunosuppressants, whereas the increased incidence of NMSC was observed only at 5 years (2.1% vs. 11.8%, p = 0.012) in the GD cohort. The mean cumulative number of NMSC in KTRs increased significantly at 3 years (p = 0.011), and 5 years (p = 0.001) post‐immunosuppressants, compared to the risks at 1 year post‐immunosuppressants, however, no differences were noted in the GD cohort.DiscussionImmunosuppressants increased the risk of NMSC in KTRs. The increased risk is likely dependent on the intensity and duration of immunosuppressants.ConclusionIn patients with a high risk of NMSC, reducing skin cancer risk should be considered in conjunction with the optimisation of treatment.