Economics of risk stratification for skin cancer screening in solid organ transplant recipients

Abstract

Background: Solid organ transplant recipients (SOTRs) have different risks of developing skin cancer depending on patient characteristics. However, there is currently no widely used tool to stratify skin cancer risk in these patients. The Skin and Ultraviolet Neoplasia Transplant Risk Assessment Calculator (SUNTRAC) is an attempt to stratify skin cancer risk in SOTRs and guide screening recommendations for those patients. Materials and methods: It was assumed that the 2022 solid organ transplant population in the United States would follow the same distribution of skin cancer risk as the population in the study that led to the development of the SUNTRAC. The total number of skin cancer screening visits and the total cost of those visits over 10 years were determined utilizing the screening recommendations in the SUNTRAC. Results: If all SOTRs received yearly skin cancer screens, 428,870 office visits would be conducted over 10 years for a total cost of $94,780,270. If the SUNTRAC were utilized, 336,666 office visits would be conducted for a 10-year cost of $74,403,186. Conclusions: Utilizing the SUNTRAC to guide skin cancer screening recommendations in SOTRs has the potential to minimize over-screening and lower the total cost of skin cancer screening visits for SOTRs. Initial studies into the applicability of the SUNTRAC have found similar risk distribution in different populations of SOTRs. Utilizing this model to guide skin cancer screening recommendations will better allocate resources to the highest risk patients while also avoiding unnecessary health care costs.