The cumulative dose of immunosuppression over time has been found to be the primary factor driving the tendency towards malignancy. Renal transplant recipients have been the most extensively studied but the risk of malignancy applies to all patients receiving long-term immunosuppression.
CUMULATIVE INCIDENCE IN XLSTAT SKIN
Another study found that skin cancers accounted for 88% of cancers in the immunosuppressed patients, with the next most frequent single malignancy being lymphoma, at 1.4%. One RCT reported that, over 20 years, 35% of their transplant patients developed NMSC alone, when for all other types of cancer the combined cumulative incidence was 19%. They are particularly at risk of developing nonmelanoma skin cancer (NMSC). This renders them at increased risk of many types of malignancy and they have been found to be between four and fourteen times more likely to develop cancer than age-matched controls. Organ transplant recipients take immunosuppressive drugs for life to prevent graft rejection. This adds to the evidence allowing clinicians to inform patients in this region of their risk. Despite changes in transplantation practice during the time since the last data were published in this region, these findings are similar to previous studies. Mean number of tumours per patient was 4, with mean interval of 12 months. 221 malignant skin tumours were found: 50.2% were SCCs, 47.1% BCCs, and 2.7% malignant melanomas. Additionally, 21 patients (3.0%) only had noninvasive tumours. The rate was 45 tumours per 1000 person-years at risk. Cumulative incidences of 4.0%, 7.5%, and 12.2% were observed for those with <5, <10, and ≥10 years follow-up, respectively. Mean length of follow-up was 7.2 years and total follow-up was 4926 person-years. Pathology records were reviewed for 709 kidney transplant recipients on immunosuppression at our hospital from 1995 to 2008. There is a need for up-to-date data for the South of England. This conveys an increased risk of malignancy, particularly skin tumours. Transplant recipients require immunosuppression to prevent graft rejection.