Increased Incidence and Mortality Associated With Skin Cancers After Cardiac Transplant

Skin cancer incidence has been shown to be increased in the context of transplant‐associated immunosuppression. There is, however, limited information specifically about the incidence of skin cancer after cardiac transplantation in the United States. A 10‐year retrospective cohort study of 6271 heart transplants at 32 US transplant centers revealed increased postprocedure incidence of nonmelanoma and melanoma skin cancers, especially cutaneous squamous cell carcinoma, for which the incidence increased from 4‐ to 30‐fold compared to the age and gender equivalent general population. Incidence of skin cancer in this study was consistent with prior single‐center data regarding cardiac transplant patients. Comparison of all‐cause mortality statistics for patients with basal cell carcinoma, squamous cell carcinoma and melanoma, respectively, demonstrated increased mortality associated with melanoma. Skin cancer screening and prophylaxis may be of some utility in reducing morbidity and mortality in cardiac transplant patients. Analysis of incidence data from a transplant database accounting for approximately one‐quarter of heart transplants in the United States during the period 1993–2004 finds an elevated risk of skin cancer, particularly cutaneous squamous cell carcinoma.