Risk of Second Malignancies in Solid Organ Transplant Recipients Who Develop Keratinocyte Cancers

Rachel D Zamoiski; Elizabeth Yanik; Todd M Gibson; Elizabeth K Cahoon; Margaret M Madeleine; Charles F Lynch; Sally Gustafson; Marc T Goodman; Melissa Skeans; Ajay K Israni; Eric A Engels; Lindsay M Morton

doi:10.1158/0008-5472.CAN-16-3291

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Risk of Second Malignancies in Solid Organ Transplant Recipients Who Develop Keratinocyte Cancers

Journal article

Open access

Peer reviewed

Risk of Second Malignancies in Solid Organ Transplant Recipients Who Develop Keratinocyte Cancers

Rachel D Zamoiski, Elizabeth Yanik, Todd M Gibson, Elizabeth K Cahoon, Margaret M Madeleine, Charles F Lynch, Sally Gustafson, Marc T Goodman, Melissa Skeans, Ajay K Israni, …

Cancer research (Chicago, Ill.), Vol.77(15), pp.4196-4203

08/01/2017

DOI: 10.1158/0008-5472.CAN-16-3291

PMCID: PMC5540772

PMID: 28615224

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Abstract

Solid organ transplant recipients have increased risk for developing keratinocyte cancers, including cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), in part as a result of immunosuppressive medications administered to prevent graft rejection. In the general population, keratinocyte cancers are associated with increased risks of subsequent malignancy, however, the risk in organ transplant populations has not been evaluated. We addressed this question by linking the U.S. Scientific Registry of Transplant Recipients, which includes data on keratinocyte cancer occurrence, with 15 state cancer registries. Risk of developing malignancies after keratinocyte cancer was assessed among 118,440 Caucasian solid organ transplant recipients using multivariate Cox regression models. Cutaneous SCC occurrence ( = 6,169) was associated with 1.44-fold increased risk [95% confidence interval (CI), 1.31-1.59] for developing later malignancies. Risks were particularly elevated for non-cutaneous SCC, including those of the oral cavity/pharynx (HR, 5.60; 95% CI, 4.18-7.50) and lung (HR, 1.66; 95% CI, 1.16-2.31). Cutaneous SCC was also associated with increased risk of human papillomavirus-related cancers, including anal cancer (HR, 2.77; 95% CI, 1.29-5.96) and female genital cancers (HR, 3.43; 95% CI, 1.44-8.19). In contrast, BCC ( = 3,669) was not associated with overall risk of later malignancy (HR, 0.98; 95% CI, 0.87-1.12), including any SCC. Our results suggest that transplant recipients with cutaneous SCC, but not BCC, have an increased risk of developing other SCC. These findings somewhat differ from those for the general population and suggest a shared etiology for cutaneous SCC and other SCC in the setting of immunosuppression. Cutaneous SCC occurrence after transplantation could serve as a marker for elevated malignancy risk. .

Carcinoma, Squamous Cell - epidemiology

Humans

Risk Factors

Proportional Hazards Models

Carcinoma, Basal Cell - epidemiology

Skin Neoplasms - epidemiology

Transplant Recipients

Incidence

Neoplasms, Second Primary - epidemiology

Neoplasms, Second Primary - etiology

Carcinoma, Squamous Cell - etiology

Keratinocytes - pathology

Organ Transplantation - adverse effects

Carcinoma, Basal Cell - etiology

Registries

Skin Neoplasms - etiology

Cohort Studies

Details

Title: Subtitle: Risk of Second Malignancies in Solid Organ Transplant Recipients Who Develop Keratinocyte Cancers
Creators: Rachel D Zamoiski - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, Maryland
Elizabeth Yanik - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, Maryland
Todd M Gibson - Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
Elizabeth K Cahoon - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, Maryland
Margaret M Madeleine - Public Health Science, Fred Hutchinson Cancer Research Center, Seattle, Washington
Charles F Lynch - Department of Epidemiology, University of Iowa, Iowa City, Iowa
Sally Gustafson - Scientific Registry of Transplant Recipients, Minneapolis, Minnesota
Marc T Goodman - Cancer Prevention and Control Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
Melissa Skeans - Scientific Registry of Transplant Recipients, Minneapolis, Minnesota
Ajay K Israni - Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
Eric A Engels - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, Maryland
Lindsay M Morton - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, Maryland. mortonli@mail.nih.gov
Resource Type: Journal article
Publication Details: Cancer research (Chicago, Ill.), Vol.77(15), pp.4196-4203
Publisher: United States
DOI: 10.1158/0008-5472.CAN-16-3291
PMID: 28615224
PMCID: PMC5540772
ISSN: 0008-5472
eISSN: 1538-7445
Grant note: N01PC35142 / NCI NIH HHS HHSN261201000024C / NCI NIH HHS U58 DP000807 / NCCDPHP CDC HHS U58 DP000824 / NCCDPHP CDC HHS HHSN261201000036C / NCI NIH HHS U58 DP003875 / NCCDPHP CDC HHS U58 DP003931 / NCCDPHP CDC HHS N01PC35137 / NCI NIH HHS U58 DP003921 / NCCDPHP CDC HHS U58 DP000832 / NCCDPHP CDC HHS HHSN261201000035C / NCI NIH HHS U58 DP003879 / NCCDPHP CDC HHS HHSN261201300011C / CCR NIH HHS HHSN261201300071C / NCI NIH HHS U58 DP003920 / NCCDPHP CDC HHS U58 DP000848 / NCCDPHP CDC HHS HHSN261201000034C / NCI NIH HHS N01PC35139 / NCI NIH HHS P30 CA086862 / NCI NIH HHS HHSN261201300021C / NCI NIH HHS HHSN261201300011I / NCI NIH HHS HHSN261201000037C / NCI NIH HHS N01PC35143 / NCI NIH HHS Z99 CA999999 / Intramural NIH HHS U58 DP003883 / NCCDPHP CDC HHS HHSN261201000035I / NCI NIH HHS
Language: English
Date published: 08/01/2017
Academic Unit: Epidemiology
Record Identifier: 9983995181902771

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