Abstract
To perform the first study in Czech Republic on heart transplant recipients (HTRs), compare the risks for different types of cancer and provide comprehensive analysis of skin cancer and other types of cancer morbidity from which we would be able to derive an evidence-based skin cancer surveillance program. A retrospective cohort study was performed to determine and compare standardized morbidity ratio (SMR) of different types of cancer developed after heart transplantation. We analysed data obtained from medical documentation of 603 HTRs transplanted between 1993 and 2010. 191 incident cases of malignancy occurred in123 HTRs (20.4%). According to expectations, nonmelanoma skin cancer was the most frequent type of malignancy (119 cases) with SMR 7.6 (P < 0.001), followed by lung cancer with SMR 2.7 (P < 0.001). SMR for melanoma was 2.5, P = 0.129. Other types of cancer in HTRs (prostate and kidney cancer) were less frequent (SMR 2.06, P = 0.038 and SMR 2.03, P = 0.122). The risk of malignancy development is significantly higher for HTRs compared to the general population. Squamous cell carcinoma of the skin is the most frequent type of cancer followed by basal cell carcinoma. These findings emphasise the importance of regular skin cancer screening in HTRs.
Highlights
Organ transplant recipients are at increased risk of developing malignancies compared to the general population
A total of 83 patients were excluded from further analysis due to a diagnosis of cancer before heart transplantation (HT) or within the first year after HT, resulting in a final count of 603 patients (493 men and 110 women)
An standardized morbidity ratio (SMR) for developing skin cancer was estimated to be 7.6 (P
Summary
Organ transplant recipients are at increased risk of developing malignancies compared to the general population. The risk ranges from 4% to 18% and is estimated to be more than 100 times higher than the general population[1,2]. Skin cancer is the most frequent malignancy among HTRs. A number of studies have reported a higher incidence of other cancers, such as lymphoproliferative diseases, lung cancer or uterine and cervical dysplasia[3,4]. This study analyses the data of post-transplant malignancies among HTRs in the CzechRepublic. The incidence, spectrum, risk factors and clinical impact of post transplant malignancy were investigated retrospectively in a cohort of 603 heart transplant recipients
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Schedule a callMore From: Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia
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