Kidney-TRANSPLANT Patients at Higher Melanoma Risk

Kidney-transplant patients are nearly four times more likely than the general population to develop melanoma, the most deadly form of skin cancer, according to a new study published in the Nov.

1 issue of Cancer.

"If you are living with a kidney transplant, you should be aware of the risk of cancer, particularly melanoma," says study author Christopher S. Hollenbeak, an assistant professor of surgery and health-evaluation sciences at Pennsylvania State College of Medicine.

Hollenbeak conducted the study because previous studies looking at the risk of melanoma among kidney-transplant patients had produced conflicting results. One study, for instance, followed more than 5,000 patients for more than 24 years and found no increased risk. But another one looked at more than 2,500 kidney-transplant and heart-transplant recipients for 30 years and found a 3.4-fold increased risk.

Hollenbeak's team examined nearly 90,000 patients who had undergone kidney transplants between 1988 and 1998, using the U.S.

Renal Data System. Of these, 246 people got melanoma. This risk was 3.6 times greater than the general population.

The risk of melanoma was greatest in men and increased with age, the researchers found. And while women were also at increased risk, their risk was markedly lower than men's and did not increase with age. Blacks were seven times less likely to develop melanoma than other races, the scientists says.

Did the finding surprise Hollenbeak?

"Yes, it did," he says. "That's a pretty big increase in risk."

Kidney-transplant patients receive long-term immunosuppressant drugs, usually for the rest of their lives, and it is known that immunosuppression is associated with melanoma risk. Other risk factors for melanoma include atypical moles, a history of blistering sunburns and a personal or family history of malignant melanoma.

An estimated 59,580 Americans will be diagnosed with melanoma this year, according to the American Cancer Society, and nearly 8,000 will die of the disease this year.

Kidney-transplant patients also face a higher risk of other types of skin cancers, the study authors said.

"Melanoma is much more rare than some other types of cancer," Hollenbeak says, "but much more devastating."

It accounts for only about 4 percent of all skin-cancer cases, but causes the most skin-cancer deaths, according to the cancer society. Other skin cancers are usually highly curable.

A retired transplant surgeon praises the study.

"This is really an extremely well-done study, and an important study," says Dr. Myron Kauffman, a medical consultant for United Network for Organ Sharing.

The take-home point for kidney-transplant patients, Hollenbeak says, is awareness.

"It's important to learn from your doctor how to do a self exam to check for these things," he says.

Kidney-transplant patients should also have regular visits to a dermatologist, Hollenbeak adds.