Benign prostatic hyperplasia (BPH) is highly prevalent among older men, yet its population-level assessment often depends on physician diagnosis, which may vary by healthcare access and reporting behavior. In China, substantial urban-rural differences in healthcare utilization raise questions about whether reported differences in BPH reflect true variation or diagnostic patterns. This study therefore examined urban-rural differences in self-reported physician-diagnosed BPH and associated factors using nationally representative data. We conducted a cross-sectional analysis of 8455 men aged 45 years and older using data from Wave 4 (2018) of the China Health and Retirement Longitudinal Study (CHARLS). BPH status was defined based on self-reported physician diagnosis. Urban-rural differences in reported BPH were compared, and multivariable logistic regression models were used to examine factors associated with reported BPH diagnosis. Of 8455 participants, the overall proportion reported a physician diagnosis of BPH was 11.9%, with subgroup-specific proportions of 18.4% in urban men and 10.1% in rural men. After adjustment for sociodemographic, lifestyle, and health-related variables, rural residence was associated with lower odds of reporting BPH (aOR 0.61, 95% CI 0.51-0.72). Several associations differed by residence, including a positive association between moderate physical activity and reported BPH in urban men, and inverse associations for longer sleep duration and regular alcohol consumption in rural men (P < .05). Urban men were more likely than rural men to report a physician diagnosis of BPH. Multiple sociodemographic and lifestyle factors were statistically associated with reported BPH, with some variation by residence. Given the cross-sectional design and self-reported measures, these findings reflect patterns of reporting and diagnosis rather than confirmed differences in underlying disease prevalence. Longitudinal studies using validated clinical assessments are needed to further clarify these relationships.

Abstract Purpose The increasing incidence of urologic malignancy after renal transplantation (RT) has become a leading cause of recipient mortality. However, no recent analyses have been performed to identify the risk factors for post-transplant urologic malignancy (PTUM) and to evaluate the effect of PTUM on RT outcomes. Materials and methods This retrospective, population-based cohort study was based on Organ Procurement and Transplantation Network data. Results A total of 268,606 recipients underwent RT from January 2000 to December 2019 and met the inclusion criteria. Of these, 2,079 (0.77%), 1,983 (1.20% of male recipients), and 846 (0.32%) patients were diagnosed with renal cancer (RCa), prostate cancer (PCa), and bladder cancer (BCa), respectively, after RT. Urologic malignancy was a major cause of patient death after RT (RCa: 41.5%, PCa: 23.5%, BCa: 50.4%). The 5-year survival rates of the four groups ranking from best to worst were as follows: [95% confidence interval, lower value–upper value], PCa, 93.3% [92.2%–94.4%]; cancer-free, 87.2% [87.0%–87.3%]; RCa, 87.2% [85.8%–88.7%]; BCa, 81.0% [78.4%–83.7%] ( P < 0.001 for all, except cancer-free vs. RCa, P = 1.00). Conclusions The effects of PTUM on RT outcomes differ depending on the type of malignancy. Thus, a personalized approach to screening may be an appropriate strategy to address the multitude of complex issues that RT recipients encounter.

Despite the promising potential of organic nanoscintillator-mediated radiodynamic therapy (RDT) in enhancing the effectiveness of immunotherapy, their cutaneous phototoxicity exacerbates the risk for immune-related adverse events (irAEs). Herein, we demonstrate that organic nanoscintillators, when combined with checkpoint blockade immunotherapy and exposed to X-ray-induced RDT, can trigger cutaneous irAEs. To address this challenge, we engineered diselenide-bridged silicon coatings on organic nanoscintillators, fine-tuning the steric hindrance of the protective layer by varying its thickness. This strategy enables radiation-triggered reactive oxygen species (ROS) generation while mitigating off-target phototoxicity through neutralizing ROS. By optimizing the steric hindrance to precisely control energy transfer between the organic nanoscintillators and surrounding oxygen molecules, we effectively reduce phototoxicity and mitigate off-tumor effects through engineered surface protection. Under X-ray irradiation exposure, the steric hindrance is rapidly deactivated through the dissociation of the silicon coating, activating RDT and inducing abundant ROS generation within tumor cells. In an orthotopic 4T1 breast cancer model, intravenous administration of these surface-engineered nanoscintillators, combined with anti-programmed death-1 (anti-PD-1) antibodies, results in robust anti-tumor immune responses, while minimizing cutaneous irAEs. This work offers valuable insights into how surface engineering can modulate the delicate balance between anti-tumor efficacy and off-tumor toxicity in nanoscintillator-mediated RDT. (c) 2025 Published by Elsevier B.V. on behalf of Chinese Chemical Society and Institute of Materia Medica, Chinese Academy of Medical Sciences.

AIM:To estimate the prevalence of nocturia in middle-aged and elderly men and evaluate its associated factors and changes over time. METHODS:Data of middle-aged and older men aged ≥40 years from the 2007-2008 and 2017-2020 cycles of the National Health and Nutrition Examination Survey were retrospectively analyzed. The prevalence of nocturia was estimated using participant questionnaires on nocturia, lifestyle-related factors, and health factors, and its decadal changes were examined using multivariate logistic regression analysis to determine related factors associated with the prevalence of nocturia. RESULTS:The prevalence of nocturia was 38.0% in 2007-2008 and 39.6% in 2017-2020, with no significant increase observed (P = 0.3989). Being a non-Hispanic black was positively correlated with nocturia (adjusted odds ratio [AOR] = 1.54, 1.22-1.93, P < 0.001), whereas the correlation with being a Mexican American disappeared (AOR = 1.25, 0.90-1.73, P = 0.187). Diabetes (AOR = 1.32, 1.07-1.64, P = 0.010) and sleep disorders (AOR = 1.31, 1.07-1.60, P = 0.008) showed a statistically significant positive correlation with nocturia, whereas a significant negative correlation was observed between employment (AOR = 0.66, 0.54-0.82, P < 0.001) and nocturia. Above-high-school education (AOR = 0.60, 0.47-0.76, P < 0.001) showed a constant trend toward a negative correlation with nocturia. The correlation between high school education or general educational development and nocturia disappeared (AOR = 0.81, 0.62-1.05, P = 0.112). CONCLUSION:Diabetes and sleep disorders contribute to the development of nocturia, while work and high educational attainment can actively combat nocturia. Geriatr Gerontol Int 2024; 24: 1308-1314.

Cadmium is a common environmental pollutant associated with various health risks. Its neurotoxic, muscle-damaging, and pro-inflammatory properties may be related to overactive bladder (OAB), though few studies have assessed its impact on urinary function. This study aimed to examine the potential link between cadmium exposure and OAB. Using data from the 2007-2020 National Health and Nutrition Examination Survey (NHANES), we analyzed adults aged 40 and older (n = 15,467) in a cross-sectional design. OAB was defined by the refined Overactive Bladder Symptom Score (OABSS). Weighted multivariate logistic regression examined the associations between blood cadmium levels and OAB and its components. Age and gender stratifications were performed, and restricted cubic splines (RCS) were used to explore non-linear associations between blood cadmium and OAB. Sensitivity analyses and co-exposure analyses with other pollutants were conducted to assess OAB definition stability, subgroup differences, and exposure collinearity. The prevalence of OAB was 26.2%. While blood cadmium showed a small, non-significant positive association with overall OAB, it was inversely associated with nocturia severity (OR = 0.85, 95% CI 0.74-0.98, p < 0.05). Blood cadmium was also linked to more severe urinary incontinence in the 50-59 age group and among non-Hispanic Black adults. A non-linear association between blood cadmium and OAB was observed (p for nonlinearity = 0.016, p < 0.05). In co-exposure analyses, cadmium remained a dominant and independent factor. These findings suggest that cadmium exposure may have a complex association with OAB and may relate differently to its various components. Further research is needed to explore these relationships.

BackgroundRace is a prognostic indicator in kidney transplant (KT). However, the effect of donor-recipient race-matching on survival after KT remains unclear.MethodsUsing the United Network for Organ Sharing (UNOS) database, a retrospective study was conducted on 244,037 adults who received first-time, kidney-alone transplantation between 2000 and 2019. All patients were categorized into two groups according to donor-recipient race-matching, and the living and deceased donor KT (LDKT and DDKT) were analyzed in subgroups.ResultsOf the 244,037 patients, 149,600 (61%) were race-matched, including 107,351 (87%) Caucasian, 20,741 (31%) African Americans, 17,927 (47%) Hispanics, and 3,581 (25%) Asians. Compared with race-unmatching, race-matching showed a reduced risk of overall mortality and graft loss (unadjusted hazard ratio (HR) 0.86, 95% confidence interval (CI) 0.84–0.87; and unadjusted HR 0.79, 95% CI: 0.78–0.80, respectively). After propensity score-matching, donor-recipient race-matching was associated with a decreased risk of overall graft loss (P < 0.001) but not mortality. In subgroup analysis, race-matching was associated with higher crude mortality (HR 1.12, 95% CI: 1.06–1.20 in LDKT and HR 1.11, 95% CI: 1.09–1.14 in DDKT). However, race-matching was associated with a decreased risk of graft loss in DDKT (unadjusted HR 0.97, 95% CI: 0.96–0.99), but not in LDKT. After propensity score-matching, race-matching had better outcomes for LDKT (patient survival, P = 0.047; graft survival, P < 0.001; and death-censored graft survival, P < 0.001) and DDKT (death-censored graft survival, P = 0.018). Nonetheless, race-matching was associated with an increased adjusted mortality rate in the DDKT group (P < 0.001).ConclusionRace-matching provided modest survival advantages after KT but was not enough to influence organ offers. Cofounding factors at baseline led to a contorted crude conclusion in subgroups, which was reversed again to normal trends in the combined analysis due to Simpson's paradox caused by the LDKT/DDKT ratio.

Background: To better address the burden of benign prostatic hyperplasia (BPH) in the aging population in China, this study aimed to evaluate the incidence rate, geographical variation and risk factors of lower urinary tract symptoms suggestive of BPH (LUTS-BPH) in China.Methods: We used data from the China Health and Retirement Longitudinal Study (CHARLS) to estimate the risk factors and incidence of LUTS-BPH in the middle-aged and elderly male Chinese population. The respondents were enrolled between 2011 and 2012. LUTS-BPH occurrence was followed via a questionnaire survey every 2 years. The 2018 CHARLS data was utilized to calculate the cumulative incidence rate (CI) and CI-based age-specific risks through a proportional hazards model.Findings: The median follow-up duration was 7 years. This study included 6,713 participants, with 1,175 ultimately diagnosed with LUTS-BPH. The overall LUTS-BPH incidence was 30ꞏ2 per 1,000 man-years (uncertainty interval [UI]: 28ꞏ5–31ꞏ9). The incidence rate exhibited a linear increase between the ages of 45 and 75(r2=0.91), followed by a linear decrease between the ages of 75 and 90(r2=0.89). Age, body mass index, waist circumference, education level, self-perception of health status, nap time, smoking status, and geographic region were all found to be independently associated with the incidence risk of LUTS-BPH (P<0ꞏ05). The risk factors varied across age groups of ≤60, 60–75, and ≥75.Interpretation: LUTS-BPH incidence in Chinese citizens exhibits a linear increase with an age of 45–75 years and displays a geographic variation. These identified risk factors may be beneficial preventive guides for Chinese citizens.Funding: Grants 2021YFC2009304 (Mr. Song) and 2022YFC3602905 (Mr. Yuan) from the National Key Research and Development Program of China and grant 20220484230 (Mr. Yuan) from Beijing Nova Program.Declaration of Interest: The authors declare that they have no competing interests.Ethical Approval: Ethical approval for all the CHARLS waves was granted by the Institutional Review Board of Peking University. The IRB approval number for the main household survey, including anthropometrics, is IRB00001052-11015; the IRB approval number for biomarker collection is IRB00001052-11014.

ObjectiveTo investigate the association between age, metabolic syndrome (MetS) and improvement in nocturia in patients with benign prostate hyperplasia (BPH) receiving holmium laser enucleation of the prostate (HoLEP).MethodsThe retrospective study was conducted on patients treated for BPH using HoLEP between January 2021 and May 2022. Lower urinary tract symptoms (LUTS) were measured before surgery and at 3 months postoperatively using the International Prostate Symptom Score (IPSS). The criteria of the Adult Treatment Panel III (ATP III) were adopted to diagnose the MetS. Unsatisfactory improvement in nocturia was defined as <50% reduction in nocturia from baseline on the IPSS.ResultsOne hundred and seventy-five patients were eventually enrolled, with a median age of 69 years (IQR: 63/73). Unsatisfactory improvement in nocturia was reported in 95 patients (54%) after HoLEP. These patients were older (73; IQR: 67/79 vs. 66; IQR: 60/71, P < 0.001) and more likely to present with higher postoperative total (6; IQR: 4/9 vs. 3; IQR:2/5, P < 0.001), voiding (1; IQR: 0/3 vs. 1; IQR: 0/2, P = 0.017), and storage (4; IQR: 3/6 vs. 2; IQR: 1/4, P < 0.001) IPSS when compared to patients with satisfactory improvement in nocturia. Overall, 63 of 175 (36%) patients were diagnosed with MetS and of these, 44 (70%) reported unsatisfactory improvement in nocturia (P = 0.002) after HoLEP. Multivariate analysis revealed that age (OR = 1.117, 95% CI: 1.068–1.169, P < 0.001) and MetS (OR = 3.613, 95% CI: 1.727–7.562, P = 0.001) were independent risk factors for unsatisfactory improvement in nocturia after HoLEP.ConclusionOur findings suggest that increased age and MetS were associated with unsatisfactory improvement in nocturia in patients with BPH after HoLEP. Lifestyle management, including weight loss, may be of great importance in the improvement of nocturia.

目的 评估摩西钬激光前列腺剜除术(MoLEP)治疗良性前列腺增生(BPH)合并急性尿潴留(AUR)患者的安全性和有效性,并探究术前尿管留置状态是否会对手术的短期预后产生影响.方法 回顾性分析我院2021年1月至2022年5月收治的77例行MoLEP治疗的BPH合并AUR的患者.按照患者术前是否处于尿管留置状态将患者分为A、B两个亚组.比较A、B两组之间的术前基线资料、围手术期资料和术后3个月内随访数据之间的差异.结果 A、B两组患者术后Qmax[19.60mL/s(11.30,23.38)vs 18.00mL/s(11.90,25.00),P=0.786]、PVR[11.00mL(0.00,23.25)vs 6.00mL(0.00,20.00),P=0.498]、IPSS评分[5.50 分(3.00,8.25)vs 3.00 分(2.00,8.00),P=0.271]、QOL 评分[1.00 分(1.00,5.00)vs 2.00 分(1.00,6.00),P=0.174]及并发症发生比例无显著差异.A组患者术后IPSS评分[3.00分(2.00,8.00)vs 20.00分(16.00,25.00),P＜0.001]和 QOL 评分[1.00 分(1.00,5.00)vs 5.00 分(4.00,5.00),P＜0.001]较术前均显著降低.B 组患者术后IPSS 评分[5.50 分(3.00,8.25)vs 21.00 分(17.00,25.00),P＜0.001]和 QOL 评分[2.00 分(1.00,6.00)vs 4.00 分(4.00,5.00),P＜0.032]也较术前显著降低.结论 MoLEP可以安全有效地解除BPH伴AUR患者下尿路梗阻,进而明显改善患者下尿路症状并有效提升患者生活质量.术前尿管留置状态对BPH伴AUR患者手术短期预后无显著影响.

Background: Previous studies have shown that education level is associated with the prognosis of cadaveric kidney transplant recipients. However, it is unclear whether education affects the prognosis of living kidney transplant (LDKT) recipients. In addition, it remains to be determined whether the uneven distribution of educational levels consistently affects the prognosis of LDKT recipients across ethnic groups (White, Black, Hispanic and Asian). Methods: After establishing inclusion and exclusion criteria, we conducted a retrospective study of LDKT recipients who received their first single LDKT between 2005 and 2020. The LDKT recipients were divided into lower-and higher-education groups according to categorize the educational level of recipients, and transplant outcomes, including graft survival, patient survival, and death-censored graft survival (DCGS), were analyzed and compared. Results: Graft survival, DCGS and patient mortality were significantly better in the higher-education group compared with those in the lower-education group (P<0.001), with the risk of graft failure, death censored graft failure (DCGF) and patient mortality increasing by 11%, 15% and 7% in the lower-education group, respectively. Furthermore, compared with the higher-education group, the risk of graft failure in Black recipients increased by 18% [adjusted hazard ratio (aHR), 1.18; 95% confidence interval (CI): 1.07 to 1.30], and the risk of patient mortality among White recipients decreased by 7% (aHR), 0.93; 95% CI: 0.87 to 0.99]. However, there were no significant differences in graft failure and patient mortality among Hispanic and Asian recipients, respectively. Conclusions: This study revealed that LDKT recipients with a higher education level had better transplant outcomes. However, these transplant outcome differences were mainly found in White and Black recipients. These data confirm the significant effect of different levels of education on the prognosis of LDKT recipients.

目的 分析直出式绿激光前列腺剜除术(Green LEP)治疗良性前列腺增生(BPH)的学习曲线.方法 对2021年1月至2022年4月期间,由解放军总医院泌尿外科1名泌尿科医生行Green LEP手术的72例BPH患者进行回顾性分析.根据手术时间先后分为A、B、C 3组,每组24例.比较3组患者年龄、前列腺体积、总前列腺特异抗原(tPSA)等基线特征,以及剜除时间、血红蛋白(Hb)变化、术后近期并发症等手术相关指标,并予评估术者的学习曲线.结果 3组患者除年龄以外的基线特征差异无统计学意义,相比A组,B、C两组的手术剜除时间短[36.92(24.50,42.59)min vs 50.87(36.38,79.47)min;25.98(19.88,36.37)min vs 50.87(36.38,79.47)min,P<0.05],前列腺组织剜除效率高[0.90±0.42mL/min vs 0.56±0.32mL/min;0.94±0.39mL/min vs 0.56±0.32mL/min P<0.05].24例手术后,操作者熟练掌握Green LEP手术.3组患者术后3个月IPSS评分和QoL评分与术前相比有显著改善(P<0.05).结论 采用Green LEP术治疗BPH安全、有效,其学习曲线约为24例.

目的:探讨急性尿潴留(AUR)病史对摩西钬激光前列腺剜除术(MoLEP)治疗良性前列腺增生症(BPH)早期预后的影响.方法:回顾性分析中国人民解放军总医院第三医学中心泌尿外科医学部2021年1月至10月接受MoLEP治疗的BPH患者120例,根据是否有AUR病史分为AUR(+)组41例和AUR(-)组79例.比较两组患者围手术期指标和术后并发症的差异,探究AUR病史对术后3个月最大尿流率(Qmax)、残余尿(PVR)、国际前列腺症状评分(IPSS)及生活质量评分(QOL)的影响.结果:AUR(+)组相比AUR(-)组BMI较小[23.88(21.77,25.40)kg/m2 vs 24.80(23.25,26.22)kg/m2,P=0.018],前列腺体积较大[80.00(52.00,91.00)ml vs 58.00(47.00,80.50)ml,P=0.044],术前尿白细胞阳性比例较高[22(53.7％)vs 9(11.4％),P<0.001]差异均有统计学意义.两组患者术后3个月Qmax、PVR、IPSS评分、QOL评及并发症的差异均无统计学意义(P>0.05).两组患者术后3个月IPSS评分和QOL评分均有明显改善(P<0.001).结论:AUR病史对MoLEP治疗BPH的早期预后无不利影响.

PurposeThe incidence of end-stage renal disease (ESRD) caused by renal cell carcinoma (RCC) is increasing with the high prevalence of RCC as well as those with treatment-related renal function impairment. Worries about tumor recurrence after transplant-related immunosuppression hinder the recommendation of kidney transplantation for RCC-induced ESRD patients. However, no direct analysis has been performed to identify whether kidney transplantation can offer better survival than maintaining dialysis.Materials and methodsThis retrospective population-based cohort study was based on Organ Procurement and Transplantation Network data released in March 2021. Characteristics and outcomes were compared, including the patient and graft survival of candidates and recipients with RCC-induced ESRD etiology as well as other primary diseases.ResultsPatients with RCC-induced ESRD were older; more likely to be male, White, and obese; and more likely to have a history of diabetes and dialysis. They also had higher creatinine levels, more delayed graft function, more primary non-function, and higher Kidney Donor Profile Index score donors, compared with the glomerulonephritis (GN) group. While waiting, RCC candidates suffered the worst outcomes of all groups, a 44% (adjusted hazard ratio [aHR], 1.44 [1.27–1.62]) higher risk of removal than GN patients. After transplantation, RCC recipients demonstrated comparable patient survival and better graft survival (p=0.21 and p=0.13, respectively). Compared with still-waiting RCC patients, the RCC recipients who received kidney transplants had significantly better outcomes (13.6 [9.3–17.8] vs. 61 [52–68.4] %), decreasing the death or deteriorating risk by 84% (aHR, 0.16 [0.13–0.20]).ConclusionsPatients with RCC-induced ESRD can dramatically benefit from kidney transplantation. Hence, these patients should not be limited to transplantation by strict strategies or a delayed waiting time out of their malignancy history.

Previous studies have shown that the level of education is associated with the prognosis of cadaveric kidney transplant recipients. However, it is unclear whether education affects the prognosis of living kidney transplant recipients. In addition, it remains to be determined whether the uneven distribution of education levels consistently affects the prognosis of LDKT recipients across ethnic groups. The outcomes of LDKT recipients with different levels of education were compared to verify the difference, and the relationship between education level and prognostic risk of LDKT recipients in different races was evaluated. We conducted a retrospective study of adult recipients who received their first living single kidney transplant from 2005 to 2020. The LDKT recipients were divided into low and high education groups, and the transplant outcomes including graft survival, patient survival, and death-censored graft survival, in the LDKT recipients between these groups were analyzed and compared. The graft and patient survival rates in the high education group were better than those in the low education group (P <.001). As compared to the high education group, the risk of graft failure and mortality increased by 11% [hazard ratio (HR), 1.11 (1.06 to 1.15)] and 7% [(HR), 1.07 (1.02 to 1.13)] in the low education group, respectively. The subgroup analysis showed that White, Black, and Asian ethnic groups showed a similar trend. However, there was no significant difference in the graft and patient survival rates among Hispanic groups between the two education groups (P = 0.38 and P = 0.41, respectively). The adjusted risk of graft failure in the low education group decreased 7% [adjusted hazard ratio (aHR), 0.93 (0.88 to 0.98)] in White recipients, increased 19% [(aHR), 1.19 (1.09 to 1.31)] and 31% [(aHR), 1.31 (1.02 to 1.69)] in Black and Asian, respectively. This study showed that the high education level had better transplant outcomes in LDKT recipients, and these differences in transplant outcomes were mainly found in white, black, and Asian recipients.

Purpose Posttransplant skin cancer is the most common malignancy after patients have undergone renal transplantation. Through comprehensive observation with a large sample size nationwide, understanding the risk factors and outcome of posttransplant skin cancer will help to develop appropriate patient surveillance and disease prevention strategies. Materials and methods This retrospective population-based cohort study was based on Organ Procurement and Transplantation Network data released in March 2021. Characteristics and outcomes, including patient survival and graft survival of recipients, were compared. Risk factors for posttransplant skin cancer, cancer onset momentum, and mortality were determined. Results A total of 199,564 renal transplant recipients were included. After renal transplantation, 7,334 (3.68%), 6,093 (3.05%), and 936 (0.47%) were diagnosed with squamous cell carcinoma, basal cell carcinoma, and melanoma, respectively. Skin cancer was the major cause of death (squamous cell carcinoma: 23.8%, basal cell carcinoma: 18%, and melanoma: 41.6%). Five-year survival rates ranked from best to worst were as follows: basal cell carcinoma (96.7 [95% confidence interval: 96.3–97.2]%), squamous cell carcinoma (94.1 [93.5–94.6]%), melanoma (89.7 [87.7–91.6]%), and cancer-free (87.4 [87.2–87.5]%) (p < 0.001 for all except melanoma vs. cancer-free, p = 0.534). Regarding graft survival, death-censored graft survival, posttransplant skin cancer, and melanoma were significantly better than the cancer-free group (p < 0.001). Independent risk factors for developing posttransplant skin cancer included older age, male sex, Caucasian race, pretransplant malignancy, polycystic kidney disease-induced end-stage renal disease (ESRD), retransplantation, private health insurance, T-cell depletion induction, and tacrolimus/mycophenolic acid use. Caucasian race and pretransplant malignancy were independent risk factors for posttransplant skin cancer onset momentum. Male sex, Caucasian race, pretransplant malignancy, hypertension- or diabetes-induced ESRD, retransplantation, diabetes history, deceased donor, cyclosporin, and mTOR inhibitor use were independent risk factors for posttransplant skin cancer mortality. Conclusion Although posttransplant skin cancer is a major cause of recipient death, information regarding its impact on patient and graft survival is limited. Given the differences regarding risk factors for posttransplant skin cancer incidence, onset momentum, and mortality, personalized approaches to screening may be appropriate to address the complex issues encountered by kidney transplant recipients.