Risk of basal cell carcinoma in Swedish organ transplant recipients: a population-based study
Summary Background Risk of basal cell carcinoma (BCC) has been reported to be several‐fold increased among organ transplant recipients (OTRs). However, due to lack of reliable BCC registration, population‐based risk estimates are scarce. Objectives To characterize risk of BCC among OTRs compared wit...
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| Veröffentlicht in: | British journal of dermatology (1951) 2016-01, Vol.174 (1), p.95-103 |
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| container_title | British journal of dermatology (1951) |
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| creator | Krynitz, B. Olsson, H. Lundh Rozell, B. Lindelöf, B. Edgren, G. Smedby, K.E. |
| description | Summary
Background
Risk of basal cell carcinoma (BCC) has been reported to be several‐fold increased among organ transplant recipients (OTRs). However, due to lack of reliable BCC registration, population‐based risk estimates are scarce.
Objectives
To characterize risk of BCC among OTRs compared with the general population, and contrast with risk of cutaneous squamous cell carcinoma (SCC).
Subjects and methods
OTRs transplanted during 2004–2011 were identified through national healthcare registers and linked with the nationwide Swedish BCC Register initialized in 2004. Relative risk of BCC was expressed as standardized incidence ratios (SIR) with 95% confidence intervals (CI).
Results
Altogether, 4023 transplanted patients developed 341 BCCs during follow‐up. Compared with the general population, the relative risk of BCC was increased sixfold (SIR 6·1, 95% CI 5·4–6·9). The risk was higher in kidney and heart/lung than in liver recipients (SIRkidney 7·2, 6·3–8·3; SIRheart/lung 5·8, 4·0–8·2; SIRliver 2·6, 1·7–4·0), and risk increased with time since transplantation (Ptrend < 0·01). The SCC to BCC ratio was 1 : 1·7 and BCC developed earlier after transplantation than SCC. Distribution of anatomical sites and histological types did not differ substantially between OTR‐ and population‐BCCs.
Conclusions
Risk of BCC was strikingly elevated in OTRs compared with the general population. Risk was higher in kidney recipients and increased with follow‐up time. These findings support a tumour‐promoting effect of immunosuppressive drugs in BCC development. The low SCC to BCC ratio was possibly attributed to short follow‐up time.
What's already known about this topic?
Transplant recipients are at high risk of developing skin cancer, especially squamous cell carcinoma (SCC) but also basal cell carcinoma (BCC).
Population‐based estimates of risk of BCC are scarce due to poor registration.
What does this study add?
The relative risk of post‐transplant BCC was increased sixfold compared with the background population, and most pronounced in kidney recipients.
BCCs developed earlier after transplantation than SCCs.
Linked Comment: Li, et al, Br J Dermatol 2016; 174: 16–17. |
| doi_str_mv | 10.1111/bjd.14153 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_510960</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2311142950</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5373-702f262bd2c09b32f177359623b1153b76cb9bfc6684891372c38117485bef533</originalsourceid><addsrcrecordid>eNp9kU9vFCEYxonR2LV68AsYEi_2MC3wDrDjrba61TY18U_1YgjMMMruLExhJut--7Ludg8mygEI-fHked4HoeeUHNO8Tsy8OaYl5fAATSgIXjAK8BBNCCGyIJWAA_QkpTkhFAgnj9EBEwDAGZ2gH59cWuDQYqOT7nBtu7zpWDsflho7jz-vbOPSLxziT-3xELVPfaf9gKOtXe-sH9JrrHEf-rHTgwu-yEq2wWkYm_VT9KjVXbLPduch-vru7Zezi-Lq4-z92elVUXOQUEjCWiaYaVhNKgOspVICrwQDQ3MqI0VtKtPWQkzLaUVBshqmlMpyyo1tOcAhKra6aWX70ag-uqWOaxW0U7unRb5ZxWkeB_kvf-5uTlVOqzo3KspKASLzr7Z8H8PtaNOgli5tZqW9DWNSVAqSfXFSZvTlX-g8jNHn9IpBLqtkFd8YONpSdQwpRdvuLVCiNp2q3Kn602lmX-wUR7O0zZ68LzEDJ1tg5Tq7_reSevPh_F5yl9-lwf7e_9BxoYQEydW365m6_H59SWdlpW7gDlhluFM</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2311142950</pqid></control><display><type>article</type><title>Risk of basal cell carcinoma in Swedish organ transplant recipients: a population-based study</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Krynitz, B. ; Olsson, H. ; Lundh Rozell, B. ; Lindelöf, B. ; Edgren, G. ; Smedby, K.E.</creator><creatorcontrib>Krynitz, B. ; Olsson, H. ; Lundh Rozell, B. ; Lindelöf, B. ; Edgren, G. ; Smedby, K.E.</creatorcontrib><description>Summary
Background
Risk of basal cell carcinoma (BCC) has been reported to be several‐fold increased among organ transplant recipients (OTRs). However, due to lack of reliable BCC registration, population‐based risk estimates are scarce.
Objectives
To characterize risk of BCC among OTRs compared with the general population, and contrast with risk of cutaneous squamous cell carcinoma (SCC).
Subjects and methods
OTRs transplanted during 2004–2011 were identified through national healthcare registers and linked with the nationwide Swedish BCC Register initialized in 2004. Relative risk of BCC was expressed as standardized incidence ratios (SIR) with 95% confidence intervals (CI).
Results
Altogether, 4023 transplanted patients developed 341 BCCs during follow‐up. Compared with the general population, the relative risk of BCC was increased sixfold (SIR 6·1, 95% CI 5·4–6·9). The risk was higher in kidney and heart/lung than in liver recipients (SIRkidney 7·2, 6·3–8·3; SIRheart/lung 5·8, 4·0–8·2; SIRliver 2·6, 1·7–4·0), and risk increased with time since transplantation (Ptrend < 0·01). The SCC to BCC ratio was 1 : 1·7 and BCC developed earlier after transplantation than SCC. Distribution of anatomical sites and histological types did not differ substantially between OTR‐ and population‐BCCs.
Conclusions
Risk of BCC was strikingly elevated in OTRs compared with the general population. Risk was higher in kidney recipients and increased with follow‐up time. These findings support a tumour‐promoting effect of immunosuppressive drugs in BCC development. The low SCC to BCC ratio was possibly attributed to short follow‐up time.
What's already known about this topic?
Transplant recipients are at high risk of developing skin cancer, especially squamous cell carcinoma (SCC) but also basal cell carcinoma (BCC).
Population‐based estimates of risk of BCC are scarce due to poor registration.
What does this study add?
The relative risk of post‐transplant BCC was increased sixfold compared with the background population, and most pronounced in kidney recipients.
BCCs developed earlier after transplantation than SCCs.
Linked Comment: Li, et al, Br J Dermatol 2016; 174: 16–17.</description><identifier>ISSN: 0007-0963</identifier><identifier>ISSN: 1365-2133</identifier><identifier>EISSN: 1365-2133</identifier><identifier>DOI: 10.1111/bjd.14153</identifier><identifier>PMID: 26333521</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Age Distribution ; Aged ; Basal cell carcinoma ; Carcinoma, Basal Cell - epidemiology ; Drug development ; Female ; Health risk assessment ; Humans ; Immunosuppressive agents ; Incidence ; Kidneys ; Male ; Middle Aged ; Organ Transplantation - adverse effects ; Organ Transplantation - statistics & numerical data ; Population ; Population studies ; Population-based studies ; Prospective Studies ; Risk Factors ; Sex Distribution ; Skin cancer ; Skin Neoplasms - epidemiology ; Squamous cell carcinoma ; Sweden - epidemiology ; Transplant Recipients - statistics & numerical data ; Transplantation ; Transplants & implants ; Tumors</subject><ispartof>British journal of dermatology (1951), 2016-01, Vol.174 (1), p.95-103</ispartof><rights>2015 British Association of Dermatologists</rights><rights>2015 British Association of Dermatologists.</rights><rights>Copyright © 2016 British Association of Dermatologists</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5373-702f262bd2c09b32f177359623b1153b76cb9bfc6684891372c38117485bef533</citedby><cites>FETCH-LOGICAL-c5373-702f262bd2c09b32f177359623b1153b76cb9bfc6684891372c38117485bef533</cites><orcidid>0000-0003-0896-1749</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbjd.14153$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbjd.14153$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26333521$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-124636$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:132761166$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Krynitz, B.</creatorcontrib><creatorcontrib>Olsson, H.</creatorcontrib><creatorcontrib>Lundh Rozell, B.</creatorcontrib><creatorcontrib>Lindelöf, B.</creatorcontrib><creatorcontrib>Edgren, G.</creatorcontrib><creatorcontrib>Smedby, K.E.</creatorcontrib><title>Risk of basal cell carcinoma in Swedish organ transplant recipients: a population-based study</title><title>British journal of dermatology (1951)</title><addtitle>Br J Dermatol</addtitle><description>Summary
Background
Risk of basal cell carcinoma (BCC) has been reported to be several‐fold increased among organ transplant recipients (OTRs). However, due to lack of reliable BCC registration, population‐based risk estimates are scarce.
Objectives
To characterize risk of BCC among OTRs compared with the general population, and contrast with risk of cutaneous squamous cell carcinoma (SCC).
Subjects and methods
OTRs transplanted during 2004–2011 were identified through national healthcare registers and linked with the nationwide Swedish BCC Register initialized in 2004. Relative risk of BCC was expressed as standardized incidence ratios (SIR) with 95% confidence intervals (CI).
Results
Altogether, 4023 transplanted patients developed 341 BCCs during follow‐up. Compared with the general population, the relative risk of BCC was increased sixfold (SIR 6·1, 95% CI 5·4–6·9). The risk was higher in kidney and heart/lung than in liver recipients (SIRkidney 7·2, 6·3–8·3; SIRheart/lung 5·8, 4·0–8·2; SIRliver 2·6, 1·7–4·0), and risk increased with time since transplantation (Ptrend < 0·01). The SCC to BCC ratio was 1 : 1·7 and BCC developed earlier after transplantation than SCC. Distribution of anatomical sites and histological types did not differ substantially between OTR‐ and population‐BCCs.
Conclusions
Risk of BCC was strikingly elevated in OTRs compared with the general population. Risk was higher in kidney recipients and increased with follow‐up time. These findings support a tumour‐promoting effect of immunosuppressive drugs in BCC development. The low SCC to BCC ratio was possibly attributed to short follow‐up time.
What's already known about this topic?
Transplant recipients are at high risk of developing skin cancer, especially squamous cell carcinoma (SCC) but also basal cell carcinoma (BCC).
Population‐based estimates of risk of BCC are scarce due to poor registration.
What does this study add?
The relative risk of post‐transplant BCC was increased sixfold compared with the background population, and most pronounced in kidney recipients.
BCCs developed earlier after transplantation than SCCs.
Linked Comment: Li, et al, Br J Dermatol 2016; 174: 16–17.</description><subject>Adult</subject><subject>Age Distribution</subject><subject>Aged</subject><subject>Basal cell carcinoma</subject><subject>Carcinoma, Basal Cell - epidemiology</subject><subject>Drug development</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Immunosuppressive agents</subject><subject>Incidence</subject><subject>Kidneys</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Organ Transplantation - adverse effects</subject><subject>Organ Transplantation - statistics & numerical data</subject><subject>Population</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Sex Distribution</subject><subject>Skin cancer</subject><subject>Skin Neoplasms - epidemiology</subject><subject>Squamous cell carcinoma</subject><subject>Sweden - epidemiology</subject><subject>Transplant Recipients - statistics & numerical data</subject><subject>Transplantation</subject><subject>Transplants & implants</subject><subject>Tumors</subject><issn>0007-0963</issn><issn>1365-2133</issn><issn>1365-2133</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9vFCEYxonR2LV68AsYEi_2MC3wDrDjrba61TY18U_1YgjMMMruLExhJut--7Ludg8mygEI-fHked4HoeeUHNO8Tsy8OaYl5fAATSgIXjAK8BBNCCGyIJWAA_QkpTkhFAgnj9EBEwDAGZ2gH59cWuDQYqOT7nBtu7zpWDsflho7jz-vbOPSLxziT-3xELVPfaf9gKOtXe-sH9JrrHEf-rHTgwu-yEq2wWkYm_VT9KjVXbLPduch-vru7Zezi-Lq4-z92elVUXOQUEjCWiaYaVhNKgOspVICrwQDQ3MqI0VtKtPWQkzLaUVBshqmlMpyyo1tOcAhKra6aWX70ag-uqWOaxW0U7unRb5ZxWkeB_kvf-5uTlVOqzo3KspKASLzr7Z8H8PtaNOgli5tZqW9DWNSVAqSfXFSZvTlX-g8jNHn9IpBLqtkFd8YONpSdQwpRdvuLVCiNp2q3Kn602lmX-wUR7O0zZ68LzEDJ1tg5Tq7_reSevPh_F5yl9-lwf7e_9BxoYQEydW365m6_H59SWdlpW7gDlhluFM</recordid><startdate>201601</startdate><enddate>201601</enddate><creator>Krynitz, B.</creator><creator>Olsson, H.</creator><creator>Lundh Rozell, B.</creator><creator>Lindelöf, B.</creator><creator>Edgren, G.</creator><creator>Smedby, K.E.</creator><general>Blackwell Publishing Ltd</general><general>Oxford University Press</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>DG8</scope><orcidid>https://orcid.org/0000-0003-0896-1749</orcidid></search><sort><creationdate>201601</creationdate><title>Risk of basal cell carcinoma in Swedish organ transplant recipients: a population-based study</title><author>Krynitz, B. ; Olsson, H. ; Lundh Rozell, B. ; Lindelöf, B. ; Edgren, G. ; Smedby, K.E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5373-702f262bd2c09b32f177359623b1153b76cb9bfc6684891372c38117485bef533</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Age Distribution</topic><topic>Aged</topic><topic>Basal cell carcinoma</topic><topic>Carcinoma, Basal Cell - epidemiology</topic><topic>Drug development</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Immunosuppressive agents</topic><topic>Incidence</topic><topic>Kidneys</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Organ Transplantation - adverse effects</topic><topic>Organ Transplantation - statistics & numerical data</topic><topic>Population</topic><topic>Population studies</topic><topic>Population-based studies</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Sex Distribution</topic><topic>Skin cancer</topic><topic>Skin Neoplasms - epidemiology</topic><topic>Squamous cell carcinoma</topic><topic>Sweden - epidemiology</topic><topic>Transplant Recipients - statistics & numerical data</topic><topic>Transplantation</topic><topic>Transplants & implants</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Krynitz, B.</creatorcontrib><creatorcontrib>Olsson, H.</creatorcontrib><creatorcontrib>Lundh Rozell, B.</creatorcontrib><creatorcontrib>Lindelöf, B.</creatorcontrib><creatorcontrib>Edgren, G.</creatorcontrib><creatorcontrib>Smedby, K.E.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Linköpings universitet</collection><jtitle>British journal of dermatology (1951)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Krynitz, B.</au><au>Olsson, H.</au><au>Lundh Rozell, B.</au><au>Lindelöf, B.</au><au>Edgren, G.</au><au>Smedby, K.E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of basal cell carcinoma in Swedish organ transplant recipients: a population-based study</atitle><jtitle>British journal of dermatology (1951)</jtitle><addtitle>Br J Dermatol</addtitle><date>2016-01</date><risdate>2016</risdate><volume>174</volume><issue>1</issue><spage>95</spage><epage>103</epage><pages>95-103</pages><issn>0007-0963</issn><issn>1365-2133</issn><eissn>1365-2133</eissn><abstract>Summary
Background
Risk of basal cell carcinoma (BCC) has been reported to be several‐fold increased among organ transplant recipients (OTRs). However, due to lack of reliable BCC registration, population‐based risk estimates are scarce.
Objectives
To characterize risk of BCC among OTRs compared with the general population, and contrast with risk of cutaneous squamous cell carcinoma (SCC).
Subjects and methods
OTRs transplanted during 2004–2011 were identified through national healthcare registers and linked with the nationwide Swedish BCC Register initialized in 2004. Relative risk of BCC was expressed as standardized incidence ratios (SIR) with 95% confidence intervals (CI).
Results
Altogether, 4023 transplanted patients developed 341 BCCs during follow‐up. Compared with the general population, the relative risk of BCC was increased sixfold (SIR 6·1, 95% CI 5·4–6·9). The risk was higher in kidney and heart/lung than in liver recipients (SIRkidney 7·2, 6·3–8·3; SIRheart/lung 5·8, 4·0–8·2; SIRliver 2·6, 1·7–4·0), and risk increased with time since transplantation (Ptrend < 0·01). The SCC to BCC ratio was 1 : 1·7 and BCC developed earlier after transplantation than SCC. Distribution of anatomical sites and histological types did not differ substantially between OTR‐ and population‐BCCs.
Conclusions
Risk of BCC was strikingly elevated in OTRs compared with the general population. Risk was higher in kidney recipients and increased with follow‐up time. These findings support a tumour‐promoting effect of immunosuppressive drugs in BCC development. The low SCC to BCC ratio was possibly attributed to short follow‐up time.
What's already known about this topic?
Transplant recipients are at high risk of developing skin cancer, especially squamous cell carcinoma (SCC) but also basal cell carcinoma (BCC).
Population‐based estimates of risk of BCC are scarce due to poor registration.
What does this study add?
The relative risk of post‐transplant BCC was increased sixfold compared with the background population, and most pronounced in kidney recipients.
BCCs developed earlier after transplantation than SCCs.
Linked Comment: Li, et al, Br J Dermatol 2016; 174: 16–17.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>26333521</pmid><doi>10.1111/bjd.14153</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-0896-1749</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0007-0963 |
| ispartof | British journal of dermatology (1951), 2016-01, Vol.174 (1), p.95-103 |
| issn | 0007-0963 1365-2133 1365-2133 |
| language | eng |
| recordid | cdi_swepub_primary_oai_swepub_ki_se_510960 |
| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Age Distribution Aged Basal cell carcinoma Carcinoma, Basal Cell - epidemiology Drug development Female Health risk assessment Humans Immunosuppressive agents Incidence Kidneys Male Middle Aged Organ Transplantation - adverse effects Organ Transplantation - statistics & numerical data Population Population studies Population-based studies Prospective Studies Risk Factors Sex Distribution Skin cancer Skin Neoplasms - epidemiology Squamous cell carcinoma Sweden - epidemiology Transplant Recipients - statistics & numerical data Transplantation Transplants & implants Tumors |
| title | Risk of basal cell carcinoma in Swedish organ transplant recipients: a population-based study |
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