People who receive a kidney transplant are nearly four times morelikely to develop melanoma, a rare but deadly form of skin cancer,according to a study in the November 1, 2005 issue of CANCER, apeer-reviewed journal of the American Cancer Society. The studyindicates that risk increased with time since transplant. Furthermore,risk was highest in men -- and with increasing age in men -- but wassignificantly lower in women and blacks.
Of the various types of skin cancer, melanoma is the deadliest, witha mortality rate up to 6 percent in some regions of the world. Theclassic risk factors for melanoma are ultraviolet radiation, commonlycaused by sunburns, a suppressed immune system, and family history ofabnormal moles. Studies demonstrate that the immune system plays acritical role in monitoring the body for -- and destroying -- earlycancerous cells, including melanoma.
Patients taking immunosuppressants after organ transplantationwould be assumed to be at higher risk for cancers. Studies show thatthis holds true for nonmelanoma skin cancers but do not agree formelanoma risk. The baseline low incidence of melanoma in the generalpopulation may contribute to conflicting data. Low incidence of diseasemeans that more people need to be studied to discern an association.
In the largest study to date, Christopher S. Hollenbeak, Ph.D.,of Penn State College of Medicine and his colleagues compared melanomaincidence rates from a registry of renal transplant patients (89,786patients) to general population data.
They found that renal transplant recipients are 3.6 times morelikely to develop melanoma than the general population. Risk increasesfive percent per year after the transplant. Though some melanomas willdevelop immediately after transplant, risk continues to increaseapproximately five percent per year from transplant. Melanoma risk isgreatest in men and increases rapidly with age. In contrast, whilewomen are at increased risk, too, their risk is significantly lowerthan men and does not increase with age. Comparison by race shows thatblacks are seven-times less likely to develop melanoma than otherraces.
"Kidney transplant patients, who are receiving long-termimmunosuppression," conclude the Dr. Hollenbeak and his colleagues,"have a 3.6-fold increase in the incidence of melanoma when compared tothe general population" and should receive regular complete skinexaminations.
Article: "Increased Incidence of Melanoma in Renal TransplantationRecipients," Christopher S. Hollenbeak, Michael M. Todd, Elizabeth M.Billingsley, Gregory Harper, Anne-Marie Dyer, Eugene J. Lengerich,CANCER; Published Online: September 26, 2005 (DOI: 10.1002/cncr.21404);Print Issue Date: November 1, 2005.
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