---
title: "Skin cancer mortality after kidney transplantation in Australia and New Zealand, 1990–2019"
id: "pubmed-42243641"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42243641"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42243641/"
doi: "10.1093/bjd/ljag232"
published_at: "2026-09-18T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Skin cancer mortality after kidney transplantation in Australia and New Zealand, 1990–2019
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42243641
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42243641/)
- **DOI:** [10.1093/bjd/ljag232](https://doi.org/10.1093%2Fbjd%2Fljag232)
- **Published At:** 2026-09-18T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Transplant recipients have substantially increased risk of dying from **skin cancer** compared with the general population; this study quantified that risk for kidney transplant recipients in Australia and New Zealand from 1990–2019. - Researchers linked the Australia and New Zealand Dialysis and Transplant Registry to national death registers to identify deaths coded as **melanoma** (C43), **keratinocyte cancer** (KC; C44) and carcinoma in situ (D04). - The cohort included 21,503 individuals receiving a first kidney transplant between 1990 and 2019 with 212,317 person-years (PY) of follow-up. - There were 251 skin cancer deaths: 82 from melanoma and 169 from KC. - Absolute mortality rates per 100,000 PY were 118.2 (total skin cancer), 38.6 (melanoma) and 79.6 (KC). - Standardized mortality ratios (SMRs) compared with the general population were 11.1 for overall skin cancer, 4.5 for melanoma and 34.5 for KC, indicating large excess mortality, particularly for KC. - Excess mortality was present across sexes, all age groups, residential areas and decades of follow-up. - Regions with high ultraviolet radiation (**UVR**) indices had the highest excess mortality: Queensland (SMR 14.8), Western Australia (SMR 13.1), and New Zealand (SMR 11.0). - The authors conclude that enhanced surveillance, prevention and rapid treatment entry are warranted for kidney transplant recipients to reduce skin cancer deaths. - Details such as specific immunosuppressive regimens, staging at diagnosis, or time from transplant to skin cancer death were not reported in the abstract and therefore are not included here.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 The University of Sydney, School of Public Health, Sydney, Australia. * 2 The Australia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia. * 3 The University of Sydney, Faculty of Medicine and Health, Sydney, Australia. * 4 Westmead Hospital, Department of Renal and Transplant Medicine, Westmead, Australia. * 5 Princess Alexandra Hospital, Department of Dermatology, Brisbane, Australia. * 6 The University of Queensland, Frazer Institute, Faculty of Medicine, Brisbane, Australia. * PMID: **42243641** * DOI: [ 10.1093/bjd/ljag232 ](https://doi.org/10.1093/bjd/ljag232) Free article Item in Clipboard # Skin cancer mortality in Australian and New Zealand kidney transplant recipients: a population-based cohort study using linked health data, 1990-2019 Dana S Forcey et al. Br J Dermatol. 2026. Free article Show details Display options Display options Format Abstract PubMed PMID Br J Dermatol Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Br+J+Dermatol%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Br+J+Dermatol%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42243641/) . 2026 Sep 18;195(4):604-613. doi: 10.1093/bjd/ljag232. ### Authors [Dana S Forcey](https://pubmed.ncbi.nlm.nih.gov/?term=Forcey+DS&cauthor_id=42243641)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42243641/#short-view-affiliation-1 "The University of Sydney, School of Public Health, Sydney, Australia.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42243641/#short-view-affiliation-2 "The Australia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia."), [Brenda Maria Rosales](https://pubmed.ncbi.nlm.nih.gov/?term=Rosales+BM&cauthor_id=42243641)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42243641/#short-view-affiliation-1 "The University of Sydney, School of Public Health, Sydney, Australia."), [Melanie L Wyld](https://pubmed.ncbi.nlm.nih.gov/?term=Wyld+ML&cauthor_id=42243641)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42243641/#short-view-affiliation-3 "The University of Sydney, Faculty of Medicine and Health, Sydney, Australia.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42243641/#short-view-affiliation-4 "Westmead Hospital, Department of Renal and Transplant Medicine, Westmead, Australia."), [Nicole De La Mata](https://pubmed.ncbi.nlm.nih.gov/?term=De+La+Mata+N&cauthor_id=42243641)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42243641/#short-view-affiliation-1 "The University of Sydney, School of Public Health, Sydney, Australia."), [Kiarash Khosrotehrani](https://pubmed.ncbi.nlm.nih.gov/?term=Khosrotehrani+K&cauthor_id=42243641)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42243641/#short-view-affiliation-5 "Princess Alexandra Hospital, Department of Dermatology, Brisbane, Australia.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42243641/#short-view-affiliation-6 "The University of Queensland, Frazer Institute, Faculty of Medicine, Brisbane, Australia."), [Angela C Webster](https://pubmed.ncbi.nlm.nih.gov/?term=Webster+AC&cauthor_id=42243641)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42243641/#short-view-affiliation-3 "The University of Sydney, Faculty of Medicine and Health, Sydney, Australia.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42243641/#short-view-affiliation-4 "Westmead Hospital, Department of Renal and Transplant Medicine, Westmead, Australia.") ### Affiliations * 1 The University of Sydney, School of Public Health, Sydney, Australia. * 2 The Australia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia. * 3 The University of Sydney, Faculty of Medicine and Health, Sydney, Australia. * 4 Westmead Hospital, Department of Renal and Transplant Medicine, Westmead, Australia. * 5 Princess Alexandra Hospital, Department of Dermatology, Brisbane, Australia. * 6 The University of Queensland, Frazer Institute, Faculty of Medicine, Brisbane, Australia. * PMID: **42243641** * DOI: [ 10.1093/bjd/ljag232 ](https://doi.org/10.1093/bjd/ljag232) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Transplant recipients have an increased risk of skin cancer and related death compared with the general population. How demographics or geography impact on mortality is unclear. Understanding these will help identify groups at highest risk of skin cancer death. **Objectives:** To estimate skin cancer mortality rates among kidney transplant recipients in Australia and New Zealand and describe excess mortality by demographics and geography, relative to the general population, and change over time. **Methods:** We linked kidney transplant recipients from the Australia and New Zealand Dialysis and Transplant Registry with National Death Registers in Australia and New Zealand from 1990 to 2019. We identified deaths from melanoma (International Classification of Diseases 10th Revision code C43), keratinocyte cancer (KC; C44) and carcinoma in situ (D04), and estimated absolute mortality per 100 000 person-years of follow-up (PY). We used indirect standardization to estimate standardized mortality ratios (SMRs) with 95% confidence intervals (CIs) for kidney transplant recipients compared with the general population by sex, age at death, decade of death, and New Zealand or Australian state. **Results:** We included 21 503 individuals who received their first kidney transplant between 1990 and 2019. There were 251 deaths from skin cancer, 82 from melanoma and 169 from KC, over 212 317 PY of follow-up. The absolute skin cancer mortality rate was 118.2 per 100 000 PY (95% CI 104.1-134.2), 38.6 per 100 000 PY for melanoma (95% CI 31.1-48.0) and 79.6 per 100 000 PY for KC (95% CI 68.5-92.6). Skin cancer mortality was 11.1 times higher in kidney transplant recipients compared with the general population (SMR) overall, 4.5 times higher for melanoma and 34.5 times higher for KC. Excess skin cancer mortality relative to the general population was observed in both sexes, across all age groups, residential areas and decades of follow-up. Excess mortality was highest in regions with high ultraviolet radiation (UVR) indices - the Australian states of Queensland (SMR 14.8, 95% CI 11.7-18.8) and Western Australia (SMR 13.1, 95% CI 8.7-19.7), and in New Zealand (SMR 11.0, 95% CI 8.3-14.6). **Conclusions:** Kidney transplant recipients are at increased risk of skin cancer death, especially from KC, in all demographics and regions in Australia and New Zealand, especially those with high UVR indices. Enhanced surveillance and rapid treatment entry are warranted. ## Plain language summary People who have had an organ transplant have a higher risk of getting skin cancer and dying from it. This is partly due to the medications they have to take to prevent transplant rejection. However, we don’t know whether the risks of getting skin cancer and dying from it have changed over time. We also don’t know if people’s age, sex or where they live influences their risk of dying from skin cancer. We studied everyone who received a kidney transplant from 1990 to 2019 in Australia and New Zealand. We calculated how many transplant recipients died of skin cancer. We then compared the results to the general population. We did this to find out whether how often people died of skin cancer was different for transplant recipients. We found that people with kidney transplants were 11 times more likely to die of skin cancer. We then broke this down by type of skin cancer. Transplant recipients were four times more likely to die of melanoma. (Melanoma is the deadliest type of skin cancer in the general population.) They were also about 34 times more likely to die from non-melanoma skin cancer. Compared to the general population, women, young and middle-aged kidney transplant recipients, and people from areas with very high UV radiation from the sun died more often from skin cancer. Our findings highlight how important early diagnosis and treatment are for transplant recipients with skin cancer. Patients and doctors should be reminded how important it is to try and prevent skin cancer developing to begin with. © The Author(s) 2026. Published by Oxford University Press on behalf of British Association of Dermatologists. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ Cancer Mortality in People Receiving Dialysis for Kidney Failure: An Australian and New Zealand Cohort Study, 1980-2013. ](https://pubmed.ncbi.nlm.nih.gov/35500725/) Rosales BM, De La Mata N, Vajdic CM, Kelly PJ, Wyburn K, Webster AC.Rosales BM, et al.Am J Kidney Dis. 2022 Oct;80(4):449-461. doi: 10.1053/j.ajkd.2022.03.010. Epub 2022 Apr 30.Am J Kidney Dis. 2022.PMID: 35500725 * [ Cardiac Mortality in Kidney Transplant Patients: A Population-based Cohort Study 1988-2013 in Australia and New Zealand. ](https://pubmed.ncbi.nlm.nih.gov/32168042/) Wyld MLR, De La Mata NL, Masson P, O'Lone E, Kelly PJ, Webster AC.Wyld MLR, et al.Transplantation. 2021 Feb 1;105(2):413-422. doi: 10.1097/TP.0000000000003224.Transplantation. 2021.PMID: 32168042 * [ [SENTIERI - Epidemiological Study of Residents in National Priority Contaminated Sites. Sixth Report]. ](https://pubmed.ncbi.nlm.nih.gov/36825373/) Zona A, Fazzo L, Benedetti M, Bruno C, Vecchi S, Pasetto R, Minichilli F, De Santis M, Nannavecchia AM, Di Fonzo D, Contiero P, Ricci P, Bisceglia L, Manno V, Minelli G, Santoro M, Gorini F, Ancona C, Scondotto S, Soggiu ME, Scaini F, Beccaloni E, Marsili D, Villa MF, Maifredi G, Magoni M, Iavarone I; Gruppo di lavoro SENTIERI 2019-2022.Zona A, et al.Epidemiol Prev. 2023 Jan-Apr;47(1-2 Suppl 1):1-286. doi: 10.19191/EP23.1-2-S1.003.Epidemiol Prev. 2023.PMID: 36825373Italian. * [ Sex differences in mortality among binational cohort of people with chronic kidney disease: population based data linkage study. ](https://pubmed.ncbi.nlm.nih.gov/34785509/) De La Mata NL, Rosales B, MacLeod G, Kelly PJ, Masson P, Morton RL, Wyburn K, Webster AC.De La Mata NL, et al.BMJ. 2021 Nov 16;375:e068247. doi: 10.1136/BMJ-2021-068247.BMJ. 2021.PMID: 34785509Free PMC article. * [ Sex and gender as predictors for allograft and patient-relevant outcomes after kidney transplantation. ](https://pubmed.ncbi.nlm.nih.gov/39698949/) Jayanti S, Beruni NA, Chui JN, Deng D, Liang A, Chong AS, Craig JC, Foster B, Howell M, Kim S, Mannon RB, Sapir-Pichhadze R, Scholes-Robertson NJ, Strauss AT, Jaure A, West L, Cooper TE, Wong G.Jayanti S, et al.Cochrane Database Syst Rev. 2024 Dec 19;12(12):CD014966. doi: 10.1002/14651858.CD014966.pub2.Cochrane Database Syst Rev. 2024.PMID: 39698949Free PMC article. 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