Risk of Non-melanoma Skin Cancer in Kidney Transplantation Recipient: An Evidence-based Case Report

Abstract

Background: Renal transplantation is the most common organ transplantation procedure in Indonesia. Renal transplant recipients (RTRs) were found to carry 3-to-5-time higher risk of cancer compared to the normal population. Around 40% of cancers in RTR patients were non-melanoma skin cancer (NMSC). It was found to be correlated with several risk factors. The study aimed to determine the prognostic factors for NMSC in RTRs with Indonesian skin colors. Methods: The article search was conducted on three different journal databases, which were Cochrane, PubMed, and Embase. Relevant articles were appraised using critical appraisal guidelines from The Centre for Evidence-Based Medicine (CEBM), University of Oxford. Results: Four articles were selected for appraisal. Incidence of NMSC on RTRs in these studies were 25,2% (CI 24,67%-32,47%), 6,67% (CI 2,87%-10,47%), 23,67% (CI 19,38%-27,96%) and 28,57% (CI 24,67%-32,47%). Prognostic factors correlated with the incidence of NMSC on RTRs were age, sun exposure, history of sunburn, existing chronic actinic lesion, lentigo solaris, precancerous lesion including actinic keratoses, and consumption of cyclosporine and tacrolimus during maintenance therapy. Conclusion: Combination of age, environmental factors, sun exposure-related skin lesion, and immunosuppressant therapy are the main prognostic factors of NMSC on RTRs.

Keywords

• non-melanoma skin cancer
• renal transplant recipient
• renal transplantation