Oral Presentation Skin Cancer 2024

SKIN CANCER MORTALITY IN KIDNEY TRANSPLANT RECIPIENTS: AN AUSTRALIAN COHORT STUDY USING LINKED HEALTH DATA, 1980-2019 (#221)

Dana S Forcey 1 , Brenda Maria Rosales 1 , Nicole De La Mata 1 , Patrick Kelly 1 , Melanie Wyld 1 2 , Angela Webster 1 2
  1. The University of Sydney, Sydney, NSW, Australia
  2. Renal Medicine and Transplantation, Westmead Hospital, Westmead, NSW, Australia

Aims: To describe skin cancer mortality in Australian kidney transplant recipients and any differences by age, sex, initial state of registration on kidney replacement therapy and era. Methods: This population-based cohort study of Australian kidney transplant recipients analysed data from the Australian and New Zealand Dialysis and Transplantation Registry from 01/01/1980 to 31/12/2019. Date and underlying cause of death were ascertained by data linkage with the National Death Index at the Australian Institute of Health and Welfare and classified using ICD10AM codes. Results: Of the 20,954 transplant recipients with a total follow-up of 241,047 person-years (py), there were 280 deaths from skin cancer, 85 from melanoma and 195 from keratinocyte cancer. Skin cancer mortality rate was 116 per 100,000py (95% CI 103- 131) and rates fell each decade from 1980 to 2019. Caucasians account for 97% (n=271) of skin cancer deaths. Median time from first kidney transplant to death was 8 years (IQR 4-12 years) for melanoma and 12 years (IQR 7-18 years) for keratinocyte cancer. The mortality rate from skin cancer was highest in males (143 per 100,000py, 95% CI 124 – 163, compared to 76 per 100,000py, 95% CI 61 – 96 among females), those aged 50-59 years (463 per 100,000py, 95% CI 366 – 586), and among those in Queensland, followed by Western Australia and Tasmania.  Conclusions: Australian kidney transplant recipients have high rates of skin cancer mortality. Sex, age and state-based differences in skin cancer mortality may have implications for post-transplant screening programs and policy.