Squamous and basal skin cancers in 17,207 solid organ transplant recipients: Real-world data from national health insurance database in Poland

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BACKGROUND: Immunosuppressive therapy in organ transplant ensures proper graft function for many years, but it is burdened with a negative impact on the development of skin cancer in them. OBJECTIVES: To characterize the impact of immunosuppressive therapy in transplant recipients on the development of non-melanoma skin cancers (NMSC). MATERIAL AND METHODS: A total of 17,207 Polish patients who underwent liver, heart or kidney transplants between 2010 and 2022 and were on immunosuppression were included in the study. Immunosuppression was most commonly achieved using a regimen of tacrolimus (TAC) or cyclosporine A (CsA) combined with mycophenolic acid (MPA) and glucocorticosteroids (GS). Data on NMSC incidence from the National Health Fund in this population were analyzed and compared against incidence of NMSC in general Polish population in the same period. RESULTS: Renal transplant recipients demonstrated a significantly elevated risk of NMSC compared to the general population, with a 1-year cumulative incidence of 0.09% vs 0.04% (p < 0.001), a 5-year incidence of 1.21% vs 0.18% (p < 0.001) and a 10-year incidence of 4.18% vs 0.36% (p < 0.001). Liver transplant recipients exhibited an elevated risk for the development of NMSC, which persisted and increased over time (incidence of 0.09% vs 0.04% at 1 year (p < 0.001), 0.83% vs 0.18% at 5 years (p < 0.001) and 2.65% vs 0.36% at 10 years (p < 0.001)). Heart transplant recipients also showed a significantly higher cumulative incidence of NMSC at 1 year (0.09% vs 0.04%, p < 0.001), 5 years (0.89% vs 0.18%, p < 0.001) and 10 years (4.06% vs. 0.36%, p < 0.001) post-transplantation. CONCLUSIONS: Organ transplant recipients have an 2 times at 1 year, 4,5 times after 5 years and 9 times after 10 years increased risk of NMSC on average as opposed to general Polish population in the same period.

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