PR13 INCIDENCE AND SUBSEQUENT NON‐MELANOMA SKIN CANCERS IN CANTERBURY RENAL TRANSPLANT RECIPIENTS –WHAT CAN WE LEARN?

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Purpose: The aim of our study was to determine the incidence of non‐melanoma skin cancers (NMSCs) in renal transplant recipients (RTRs) in the Canterbury population and investigate the subsequent history of NMSCs in RTRs.Methods: We retrospectively reviewed the hospital notes of 96 RTRs who developed at least one NMSC. Survival analysis was used for the incidence of first NMSC following first renal transplant.Results: Of the 384 RTRs, 96 developed at least one NMSC. We identified 4 single predictors of NMSC in RTRs: older age at first transplant (p < 0.0001), transplantation after 1998 (p < 0.0001), male sex (p = 0.002) and initial immunosuppression regime (prednisone, mycophenolate and cyclosporine) (p < 0.0001). The average time from renal transplant to first NMSC presentation was 8.2 years. The ratio of SCC to BCC was 1.2:1. 11% of patients died of metastatic cutaneous SCC. The average number of NMSC was 1.67/year after discovery of the first NMSC. Older age at first transplant (p = 0.009) or at discovery of the first NMSC (p = 0.01) was associated with a higher annual rate of new NMSC. The median time to the discovery of second skin cancer was 2.2 years. Based on survival analysis, 25% of RTR will develop a second NMSC within 10 months of the first NMSC, and 75% by 4.4 years.Conclusions: NMSCs, especially SCCs are not a minor inconvenience of transplantation. We have quantified the clinical challenge of skin cancers in the RTR population and the particular subgroups at increased risk of developing skin cancers. We hope the size of the health burden of skin cancers carried by our RTRs will raise the awareness of this serious problem.