Initial skin cancer screening for solid organ transplant recipients in the United States: Delphi method development of expert consensus guidelines

• DOI: 10.1111/tri.13520
• Publication Date: 2019-09-10T12:03:36Z
• Authors: Lauren D. Crow; Anokhi Jambusaria...; Christina L. Chung; David A. Baran; Stefan E. Lowenstein; Mark Abdelmalek; Rehana L. Ahmed; Milan J. Anadkat; Selim M. Arcasoy; Daniel Berg; Kristin P. Bibee; Elizabeth Billing...; William H. Black; Travis W. Blalock; Melissa Bleicher; Daniel C. Brennan; David G. Brodland; Mariah R. Brown; Bryan T. Carroll; John A. Carucci; Timothy W. Chang; George Chaux; Carrie Ann Cusack; Daniel F. Dilling; Alden Doyle; Amir M. Emtiazjoo; Nkanyezi H. Ferguson; Scott W. Fosko; Matthew C. Fox; Simin Goral; Alice L. Gray; John R. Griffin; Ramsey R. Hachem; Shelley A. Hall; Allison M. Hanlon; Don Hayes; Gavin W. Hickey; Jonathan Holtz; Robert Samuel Hop...; Jenny Hu; Conway C. Huang; Shang I. Brian Jiang; Siddhartha G. Kap...; Edward S. Kraus; Erika D. Lease; Nicolae Leca; James C. Lee; Justin J. Leitenb...; Mary Ann Lim; Maria I. Longo; Shahid M. Malik; Jorge M. Mallea; Alan Menter; Sarah A. Myers; Marcy Neuburg; Rajiv I. Nijhawan; Douglas J. Norman; Clark C. Otley; So Yeon Paek; Amit D. Parulekar; Manisha J. Patel; Vishal Anil Patel; Timothy J. Patton; Melissa Pugliano‐...; Karthik Ranganna; Ashwin K. Ravicha...; Rachel Redenius; Garrett R. Roll; Faramarz H. Samie; Thuzar Shin; Jonathan P. Singer; Pooja Singh; Seaver L. Soon; Teresa Soriano; Ronald Squires; Thomas Stasko; Jennifer A. Stein; Sandra J. Taler; Norah A. Terrault; Christie P. Thomas; Sofya Tokman; Rade Tomic; Amanda R. Twigg; Mark A. Wigger; Nathalie C. Zeitouni; Sarah T. Arron
• Keywords: Male; Consensus; Skin Neoplasms; Delphi Technique; Guidelines as Topic; Organ Transplantation; Risk Assessment; Transplant Recipients; United States; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Humans; Female; Early Detection of Cancer

Skin cancer is the most common malignancy affecting solid organ transplant recipients (SOTR), and SOTR experience increased skin cancer-associated morbidity and mortality. There are no formal multidisciplinary guidelines for skin cancer screening after transplant, and current practices are widely variable. We conducted three rounds of Delphi method surveys with a panel of 84 U.S. dermatologists and transplant physicians to establish skin cancer screening recommendations for SOTR. The transplant team should risk stratify SOTR for screening, and dermatologists should perform skin cancer screening by full-body skin examination. SOTR with a history of skin cancer should continue regular follow-up with dermatology for skin cancer surveillance. High-risk transplant patients include thoracic organ recipients, SOTR age 50 and above, and male SOTR. High-risk Caucasian patients should be screened within 2 years after transplant, all Caucasian, Asian, Hispanic, and high-risk African American patients should be screened within 5 years after transplant. No consensus was reached regarding screening for low-risk African American SOTR. We propose a standardized approach to skin cancer screening in SOTR based on multidisciplinary expert consensus. These guidelines prioritize and emphasize the need for screening for SOTR at greatest risk for skin cancer.