Skin cancer screening in organ transplant centres in the United Kingdom: a national survey

Skin Cancer
25/09/2020

Eur J Dermatol. 2020 Aug 1;30(4):372-376. doi: 10.1684/ejd.2020.3845.

ABSTRACT

BACKGROUND: Organ transplant recipients (OTRs) have up to 500-fold increased risk of keratinocyte skin cancer (KSC). International guidelines recommend at least annual skin cancer screening for OTRs.

OBJECTIVES: To explore the current skin cancer surveillance practice in UK transplant centres across all solid organs and the barriers to surveillance.

MATERIALS AND METHODS: An online survey was sent to all 59 transplant centres in the UK specialising in kidney (n = 24), pancreas (n = 10), heart and/or lung (n = 13), liver (n = 8) and intestine (n = 4) transplants.

RESULTS: Fifty-one (86%) transplant centres responded. Twenty-eight (55%) centres provided skin cancer surveillance post-transplantation, of which 18 (64%) had a non-skin cancer specialist providing screening. Only 21 (41%) units performed a full skin examination. Eight units (29%) screened at least bi-annually in the first five years post-transplantation. Of the 23 (45%) centres that did not provide skin cancer surveillance, limitations included: reliance on patient-reported lesions (48%), lack of skin surveillance training (30%), lack of funding (48%), not a requirement in all patients (17%) and time restraints in the clinic (30%).

CONCLUSION: In the UK, many transplant units do not provide skin surveillance. Collaboration between skin cancer and transplant specialists would improve surveillance rates and reduce morbidity and mortality.