Incidence of nonmelanoma skin cancer in renal transplant recipients: A systematic review and meta-analysis.
Matinfar M, Shahidi S, et al.Journal of Research in Medical Sciences 2018; 23(14).
Aims
To conduct a systematic review and meta-analysis to estimate the incidence of Nonmelanoma skin cancer (NMSC) among renal transplant recipients and to ascertain the incidence of squamous cell carcinoma (SCC) and basal cell carcinoma (BCC).
Interventions
The databases PubMed, Medline, Scopus, and Web of Science were searched in February 2017 without language or time restrictions for population‑based studies on renal transplant recipients and studies that provided incidence rates of NMSC or enough information to calculate incidence rates. Two reviewers independently reviewed titles and abstracts, performed data extraction and assessed the quality of included studies. Disagreements were resolved through discussion and reevaluation, or by a third author.
Participants
29 studies comprising a total of 36,021 renal transplant recipients were included in the meta-analysis.
Outcomes
The primary outcomes measured were the pooled incidence rates of NMSC and SCC and BCC. The incidence of NMSC among renal transplant recipients in various geographic regions was also measured.
Follow-up
Average between 1.5 - 27.75 years
CET Conclusions
This is a systematic review studying the incidence of non-melanoma skin cancer in renal transplant recipients. They have in a subgroup analysis, looked at the incidence of skin cancer in different regions of the world. The authors have demonstrated in their systematic review that the incidence of non-melanoma skin cancer in renal transplant recipients varies widely (ranging from 39% in Australia and New Zealand to 1.2% in the Middle East) and that this is a risk factor after renal transplantation that patients and medical staff need to be aware of as it requires continual vigilance on both sides. Exposure to ultra violet light is probably the biggest risk factor in the immunosuppressed patient as it is in non-renal transplant recipients. My only criticism is that the systematic review seems to have missed a number of relevant references, e.g. Bordea et al[1], which was the first paper to show that the incidence in the UK was much higher than everyone believed at the time. [1] Bordea C, et al. Skin cancers in renal-transplant recipients occur more frequently than previously recognized in a temperate climate. Transplantation. 2004; 77(4): 574-9.
Quality notes
Quality assessment not appropriate
Trial registration
None