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Risk of lip cancer after solid organ transplantation in the United States.
- Source :
-
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2019 Jan; Vol. 19 (1), pp. 227-237. Date of Electronic Publication: 2018 Sep 05. - Publication Year :
- 2019
-
Abstract
- Solid organ transplant recipients have an increased risk of lip cancer, but the reasons are uncertain. Using data from the Transplant Cancer Match Study, we describe the epidemiology of lip cancer among 261 500 transplant recipients in the United States. Two hundred thirty-one lip cancers were identified, corresponding to elevated risks for both invasive and in situ lip cancers (standardized incidence ratios of 15.3 and 26.2, respectively). Invasive lip cancer incidence was associated with male sex (adjusted incidence rate ratio [aIRR] 2.01, 95% CI 1.44-2.82), transplanted organ (0.33, 0.20-0.57, for liver transplants and 3.07, 1.96-4.81, for lung transplants, compared with kidney transplants), and racial/ethnic groups other than non-Hispanic whites (0.09, 0.04-0.2). In addition, incidence increased with age and during the first 3 years following transplant, and was higher in recipients prescribed cyclosporine/azathioprine maintenance therapy (aIRR 1.79, 95% CI 1.09-2.93, compared with use of tacrolimus/mycophenolate mofetil) and following a diagnosis of cutaneous squamous cell carcinoma (4.21, 2.69-0.94). The elevation in lip cancer incidence is consistent with an effect of immunosuppression. Notably, the very strong associations with white race and history of prior skin cancer point to an important role for ultraviolet radiation exposure, and cyclosporine and azathioprine may contribute as photosensitizing or DNA damaging agents.<br /> (© 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.)
- Subjects :
- Adolescent
Adult
Aged
Azathioprine adverse effects
Carcinoma, Squamous Cell epidemiology
Carcinoma, Squamous Cell ethnology
Child
Child, Preschool
Cyclosporine adverse effects
DNA Damage
Ethnicity
Female
Humans
Immunosuppression Therapy adverse effects
Immunosuppressive Agents adverse effects
Incidence
Infant
Infant, Newborn
Lip Neoplasms epidemiology
Lip Neoplasms ethnology
Male
Middle Aged
Risk Factors
United States
Young Adult
Carcinoma, Squamous Cell diagnosis
Lip Neoplasms diagnosis
Organ Transplantation adverse effects
Postoperative Complications diagnosis
Transplant Recipients
Subjects
Details
- Language :
- English
- ISSN :
- 1600-6143
- Volume :
- 19
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 30074684
- Full Text :
- https://doi.org/10.1111/ajt.15052