Pain identifies squamous cell carcinoma in organ transplant recipients: The SCOPE-ITSCC PAIN study

TY - JOUR

T1 - Pain identifies squamous cell carcinoma in organ transplant recipients

T2 - The SCOPE-ITSCC PAIN study

AU - Bouwes Bavinck, J. N.

AU - Harwood, C. A.

AU - Genders, R. E.

AU - Wisgerhof, H. C.

AU - Plasmeijer, E. I.

AU - Mitchell, L.

AU - Olasz, E. B.

AU - Mosel, D. D.

AU - Pokorney, M. S.

AU - Serra, A. L.

AU - Feldmeyer, L.

AU - Baumann Conzett, K.

AU - Piaserico, S.

AU - Belloni Fortina, A.

AU - Jahn, K.

AU - Geusau, A.

AU - Gerritsen, M. J. P.

AU - Seçkin, D.

AU - Güleç, A. T.

AU - Cetkovská, P.

AU - Ricar, J.

AU - Imko-Walczuk, B.

AU - Proby, C. M.

AU - Hofbauer, G. F. L.

PY - 2014/3

Y1 - 2014/3

N2 - Organ transplant recipients (OTR) are at high risk for cutaneous squamous cell carcinomas (SCC). We aimed to define clinically meaningful patient-reported warning signals predicting the presence of invasive SCC. Patient-reported signs and symptoms of 812 consecutively biopsied skin lesions from 410 OTR were determined by questionnaire and physical examination and related to the subsequent biopsy-proven diagnoses. Receiver-operating characteristic (ROC) curve analyses were used as a measure of distinction between the predictive values of patient-reported warning signals and the occurrence of SCC. Pain was an independent predictive patient-reported warning signal for a biopsy-proven invasive SCC. The odds ratio from the fully adjusted model predicting SCC was 4.4 (95% confidence interval: 2.4-8.2). Higher scores on the visual analog scale (VAS) for pain were associated with a greater likelihood for the presence of SCC compared to none or mild pain. The for scores on the VAS from 1 to 3, 4 to 6 and 7 to 10 were 4.9 (2.2-10.5), 2.3 (0.96-5.5) and 16.5 (3.6-75.8), respectively. Pain is the most powerful patient-reported warning signal for invasive cutaneous SCC in OTR. Empowerment of patients by education could accelerate diagnosis and treatment of cutaneous SCC.

AB - Organ transplant recipients (OTR) are at high risk for cutaneous squamous cell carcinomas (SCC). We aimed to define clinically meaningful patient-reported warning signals predicting the presence of invasive SCC. Patient-reported signs and symptoms of 812 consecutively biopsied skin lesions from 410 OTR were determined by questionnaire and physical examination and related to the subsequent biopsy-proven diagnoses. Receiver-operating characteristic (ROC) curve analyses were used as a measure of distinction between the predictive values of patient-reported warning signals and the occurrence of SCC. Pain was an independent predictive patient-reported warning signal for a biopsy-proven invasive SCC. The odds ratio from the fully adjusted model predicting SCC was 4.4 (95% confidence interval: 2.4-8.2). Higher scores on the visual analog scale (VAS) for pain were associated with a greater likelihood for the presence of SCC compared to none or mild pain. The for scores on the VAS from 1 to 3, 4 to 6 and 7 to 10 were 4.9 (2.2-10.5), 2.3 (0.96-5.5) and 16.5 (3.6-75.8), respectively. Pain is the most powerful patient-reported warning signal for invasive cutaneous SCC in OTR. Empowerment of patients by education could accelerate diagnosis and treatment of cutaneous SCC.

KW - Adverse effect

KW - pain

KW - squamous cell carcinoma

UR - https://www.scopus.com/pages/publications/84896707542

U2 - 10.1111/ajt.12587

DO - 10.1111/ajt.12587

M3 - Article

C2 - 24730051

AN - SCOPUS:84896707542

SN - 1600-6135

VL - 14

SP - 668

EP - 676

JO - American Journal of Transplantation

JF - American Journal of Transplantation

IS - 3

ER -