SUNTRAC tool shows efficiency in detecting skin cancer among transplant recipients

December 2022 Clinical Practice Nalinee Pandey

According to a recent study published in JAMA Dermatology, the Skin and UV Neoplasia Transplant Risk Assessment Calculator (SUNTRAC) tool continues to show its efficacy in an independent population other than those used in its creation.

Individuals undergoing solid organ transplants have high chances (14-37% recipients) of developing skin cancer within ten years of transplantation. Several tools have been developed to assess the risk of skin cancers in organ transplant recipients. One such tool, SUNTRAC, proposed in 2019, showed good prognostic ability in assessing the risk of skin cancer. Recently, Gómez-Tomás and colleagues have performed validation of the SUNTRAC tool in two independent European cohorts.

Study Design

The retrospective validation study included data from 3,421 solid organ transplant recipients (SOTRs) from cohorts in the Netherlands and Spain. The participants had a mean age of 53 years, 63.2% were men, and the majority were white (82.7%). The primary aim of this study was to evaluate the efficiency of SUNTRAC tool in identifying organ recipients with an increased risk of skin cancer.  Towards this, SUNTRAC scores were calibrated using criteria such as race, sex, age, pre-transplant history of skin cancer and type of organ transplant. Next, the participants were stratified in respective risk based on SUNTRAC score (low risk, 0-6 points; medium risk, 7-13 points; high risk, 14-17 points; very high risk, 18-22 points).

Main Findings

The analysis of SUNTRAC scores revealed that the higher scores were indeed associated with a greater risk of skin cancer. The increased rates in each groups were found to be correlated with increased SUNTRAC scores. For instance, the scores in the medium risk (subdistribution HR [SHR] = 6.8; 95% CI), high risk (SHR = 15.9; 95% CI), and very high risk (SHR = 54.8; 95% CI) were 3.8-12.1, 8.9-28.4, and 29.1-102.9, respectively. In fact, a one-point increase in the SUNTRAC score was associated with a 25% increase in the risk of skin cancer.

Conclusion

The findings demonstrate the efficiency of the SUNTRAC tool in assessing the risk of skin cancer in SOTRs. Future prospective randomised trials are needed to fully assess the effectiveness of the tool.

Reference

Gómez-Tomás Á, et al. JAMA Dermatol. 2022;doi:10.1001/jamadermatol.2022.4820.

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