THE RISK OF SKIN-CANCER IN RENAL-TRANSPLANT RECIPIENTS IN QUEENSLAND,AUSTRALIA

A long-term retrospective follow-up study was performed to evaluate th e risk of skin cancer in 1098 renal transplant recipients in Queenslan d, Australia, In a subgroup, we also assessed the influence of immunos uppressive therapy on the risk of developing skin cancer: cyclosporine alone or in combination with prednisolone; azathioprine alone or in c ombination with prednisolone; or the combination of cyclosporine and a zathioprine with or without prednisolone. The cumulative incidence of developing skin cancer, calculated by life table analysis, increased p rogressively from 7% after 1 year of immunosuppression to 45% after 11 years and to 70% after 20 years of immunosuppression. Multivariate an alysis in a subgroup comparing the risk of developing skin cancer in p atients on either long-term cyclosporine or azathioprine (each with or without prednisolone) and in patients on the combination of cyclospor ine and azathioprine (with or without prednisolone) showed no differen ces between the groups. We conclude that it is likely that the increas ed risk of skin cancer associated with immunosuppression is independen t of the agent(s) used and is a result of the immunosuppression per se .