Original articleMelanoma incidence, stage, and survival after solid organ transplant: A population-based cohort study in Ontario, Canada
Section snippets
Patients and methods
We conducted a retrospective, observational, inception cohort study using population-based administrative health databases that were linked using unique encoded identifiers at ICES in Toronto, Canada. Approval of the study was granted by the Women's College Hospital Research Ethics Board, which allowed a consent waiver as we used deidentified administrative databases held securely at ICES.
Using the Canadian Organ Replacement Register, which records data on all transplants in Canada, we
Results
A total of 19 910 patients received a solid organ transplant in Ontario between 1991 and 2012. Exclusions were made based on the following criteria: not the first transplant (n = 1888), residence outside of Ontario (n = 4429), age younger than 18 years (n = 1128), bowel transplant (n = 13), pretransplant melanoma (n = 29), death within 90 days after transplant (n = 564), and kidney graft failure within 90 days (n = 439). The final transplant cohort consisted of 11 420 patients whose
Discussion
In this population-based cohort study, we found that solid organ transplant recipients had a significantly greater risk of developing melanoma overall and had melanoma diagnosed at a later stage than age- and sex-matched individuals from the nontransplant population. Posttransplant melanoma was also associated with lower melanoma-specific survival compared with melanoma in the nontransplant population. Transplant recipients who developed melanoma had an increased overall mortality compared with
References (42)
- et al.
Survival after cutaneous melanoma in kidney transplant recipients: a population-based matched cohort study
Am J Transplant
(2014) - et al.
Melanoma risk and survival among organ transplant recipients
J Invest Dermatol
(2015) - et al.
Skin cancer in kidney and heart transplant recipients and different long-term immunosuppressive therapy regimens
J Am Acad Dermatol
(1999) - et al.
Incidence and predictors of cancer following kidney transplantation in childhood
Am J Transplant
(2017) - et al.
Donor cancer transmission in kidney transplantation: a systematic review
Am J Transplant
(2013) - et al.
Improved keratinocyte carcinoma outcomes with annual dermatology assessment after solid organ transplantation: population-based cohort study
Am J Transplant
(2019) - et al.
Cancer screening recommendations for solid organ transplant recipients: a systematic review of clinical practice guidelines
Am J Transplant
(2017) - et al.
Skin cancer screening after solid organ transplantation: survey of practices in Canada
Am J Transplant
(2019) - et al.
Awareness of skin cancer by kidney transplant patients
J Am Acad Dermatol
(1999) - et al.
[Dermatologic follow-up and evaluation of skin tumours in renal transplant patients]
Ann Dermatol Venereol
(2007)
Melanoma in organ transplant recipients: clinicopathological features and outcome in 100 cases
Am J Transplant
Cancer statistics, 2017
CA Cancer J Clin
Canadian Cancer Statistics 2016
Immunosuppressive therapy and malignancy in organ transplant recipients: a systematic review
Drugs
Organ transplantation and skin cancer: basic problems and new perspectives
Exp Dermatol
Systematic review of melanoma incidence and prognosis in solid organ transplant recipients
Transplant Res
Cancer stage at diagnosis in patients infected with the human immunodeficiency virus and transplant recipients
Cancer
Cutaneous malignant melanoma in the Swedish organ transplantation cohort: a study of clinicopathological characteristics and mortality
J Am Acad Dermatol
Comprehensive capture of cutaneous melanoma by the Ontario Cancer Registry: validation study using community pathology reports
Cancer Causes Control
Final version of 2009 AJCC melanoma staging and classification
J Clin Oncol
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Funding sources: Supported by the Canadian Dermatology Foundation. The work was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care. Parts of this material are based on data and information provided by Cancer Care Ontario (CCO). The opinions, results, views, and conclusions reported in this article are those of the authors and do not necessarily reflect those of CCO. No endorsement by CCO is intended or should be inferred.
Disclosure: Dr Austin is supported in part by a Mid-Career Investigator Award from the Heart & Stroke Foundation. Dr Rochon holds the Retired Teachers of Ontario/Les enseignantes et enseignants retraites de l'Ontario Chair in Geriatric Medicine from the University of Toronto. Drs Park and Dahlke, Ms Fung, Ms Kitchen, and Dr Chan have no conflicts of interest to declare.
IRB approval status: Approved by Women's College Hospital.
Reprints not available from the authors.