Factors associated with skin cancer in lung transplant recipients: A single‐center experience

Background Skin cancer is common after solid organ transplantation, but few have investigated it after lung transplant (LTx). Objective We assessed incidence and predictors of non‐melanoma skin cancer (NMSC) post‐LTx. Methods We studied patients who underwent LTx at our center from 2012 to 2015. Results Of 287 patients, mean age was 59.6 ± 11 years, 170 (59.2%) were men, and 231 (80.5%) were white. Seventy‐six (26.5%) developed NMSC over a median follow‐up of 32 months (IQR, 23‐45). Of those with NMSC, 37% developed subsequent skin cancer of the same type. Independent predictors of decreased odds of NMSC and squamous cell carcinoma (SCC) were non‐white race (P = .002; P = .003) and body mass index >30 kg/m2 compared with underweight patients (P = .001, P = .009). Patients with skin cancer pre‐LTx had higher risk of post‐LTx skin cancer (P = .02). Voriconazole use ≥100 days was associated with increased risk of SCC (P = .03), but not increased risk of basal cell carcinoma. Out of 76, 4 (5.3%) died from skin cancer. Limitations Retrospective, single‐center study. Conclusion Squamous cell carcinoma risk post‐LTx may increase with prolonged voriconazole use in white patients with pre‐LTx history of skin cancer, whereas excess body weight may be protective from NMSC. Regular pre‐ and post‐LTx skin cancer screenings and guidelines are warranted.