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Warkworth skin cancer doctor David Hassan has been advocating for mandated and funded skin cancer checks for people who have had organ transplants, citing their significantly increased risk of cancer.
Hassan, who specialises in skin cancer screening and minor surgery, was motivated to raise awareness of the issue with the Government after treating a liver transplant patient, who had advanced skin cancer, at his SunDocs practice.
“I had a patient who’s passed away now. He had a massive growth on his forehead that came out of nowhere and he’d had a liver transplant a few years beforehand,” Hassan said.
“There was no regular checking that was funded after his transplant and it just seemed unfair.”
He said patients on anti-rejection, immunosuppressant drugs after organ transplants were 500 times more likely to develop squamous cell carcinomas (skin cancers) than the general population.
“By suppressing your immune system it’s not as able to pick up early skin cancers and get rid of them.
There’s about 1000 patients that have had transplants across NZ and they all have elevated risk.”
Hassan said skin cancers were also more likely to become aggressive and life-threatening in transplant recipients, adding they were more likely to die from skin cancer than from transplant failure.
He said a national skin cancer screening programme would be low-cost relative to the benefits, given the number of transplant recipients nationwide, and early detection could reduce expensive hospital treatment.
“Having surgery in hospital costs about 10 times more than having it done in the community. So if we can do more surgeries while things are small, then it will save the system in the long run.”
Hassan proposed a risk-based screening model delivered through primary care skin cancer clinics with more frequent checks for higher-risk patients and less frequent checks for lower-risk groups.
“So the screening would be determined by your level of risk,” he said.
He added that cost remained a major barrier for patients who were often unable to work full time after organ failure and were often without private health insurance.
“To have a skin check from a qualified professional is $200 to $300. If you need that every three months then that makes it out of many people’s league.”
Hassan said he had raised the issue with Health Minister Simeon Brown and talked with Chief Medical Officer Helen Stokes-Lampard, who he said supported efforts to secure funding.
“It’s pretty difficult to get funding for new streams of care. It’s a little bit of a hot potato as to who pays for the surgical side or the skin cancer side or the transplant side, but we’re having some wins.
“We have a lot of skin cancer doctors around the country. This is the perfect group to get funding to see patients according to their risk.”
NZ Skin Cancer Doctor Society (NZSCD) recognised Hassan for contributions to community-based skin cancer care by awarding him the NZSCD Member of the Year 2024.
In October last year, Hassan was also awarded the NZSCD Media Ambassador award for his work in the prevention of melanoma for organ transplant patients.
