Reducing non-melanoma skin cancer risk in renal transplant recipients

Nephrology (Carlton). 2021 Nov;26(11):907-919. doi: 10.1111/nep.13939. Epub 2021 Jul 28.

Abstract

With an increasing number of renal transplant recipients (RTRs) and improving patient survival, a higher incidence of non-melanoma skin cancer (NMSC) has been observed. NMSC in RTRs are often more numerous and biologically more aggressive than the general population, thus contributing towards an increase in morbidity and to a lesser degree, mortality. The resultant cumulative health and financial burden is a recognized concern. Proposed strategies in mitigating risks of developing NMSC and early therapeutic options thereof include tailored modification of immunosuppressants in conjunction with sun protection in all transplant patients. This review highlights the clinical and financial burden of transplant-associated skin cancers, carcinogenic mechanisms in association with immunosuppression, importance of skin cancer awareness campaign and integrated transplant skin clinic, and the potential role of chemoprotective agents. A scheme is proposed for primary and secondary prevention of NMSC based on the available evidence.

Keywords: non-melanoma skin carcinoma; renal transplant; skin cancer; solid organ transplant.

Publication types

  • Review

MeSH terms

  • Animals
  • Anticarcinogenic Agents / therapeutic use
  • Humans
  • Immunocompromised Host
  • Immunosuppressive Agents / adverse effects
  • Incidence
  • Kidney Transplantation / adverse effects*
  • Prognosis
  • Protective Factors
  • Risk Assessment
  • Risk Factors
  • Skin Neoplasms / immunology
  • Skin Neoplasms / mortality
  • Skin Neoplasms / prevention & control*

Substances

  • Anticarcinogenic Agents
  • Immunosuppressive Agents