Many heart transplant patients develop numerous skin cancers

January 01, 0001

Many heart transplant patients develop numerous skin cancers

The aim of this study by researchers from the UK was to examine the incidence, tumor burden, and risk factors for nonmelanoma and other skin cancer types in a heart transplant cohort. A retrospective review of patient medical records of all heart transplant recipients at Mayo Clinic from 1988 to 2006 was conducted.

In total, 312 heart transplant patients had 1395 new skin cancers in 2097 person-years (mean, 0.43 per year per patient) with a range of 0 to 306 for squamous cell carcinoma (SCC) and 0 to 17 for basal cell carcinoma (BCC). The cumulative incidence rates of any skin cancer were 20.4%, 37.5%, and 46.4% at 5, 10, and 15 years after heart transplant, respectively. Cumulative incidence of SCC after the first BCC was 98.1% within 7 years. Multivariate analysis showed that posttransplant nonskin cancer, increased age, and heart failure etiologic factors other than idiopathic disease were associated with increased risk of SCC. Posttransplant herpes simplex viral infection, increased age, and use of mycophenolate mofetil for immunosuppression were associated with increased risk of BCC.

The researchers concluded: "With prolonged survival, many heart transplant patients have numerous skin cancers. Vigilant sun protection practices, skin cancer education, and regular skin examination are appropriate interventions in these high-risk patients."

Many of these skin cancers can be prevented, identified and managed at the family physician level.

For the full abstract, click here.

Arch Dermatol 145(12):1391-1396, December 2009
© 2009 American Medical Association
Incidence of and Risk Factors for Skin Cancer After Heart Transplant. Jerry D. Brewer, MD; Oscar R. Colegio, MD, PhD; P. Kim Phillips, MD et al.

Category: S. Skin Keywords: incidence, risk factors, skin cancer, heart transplant, retrospective review of patient medical records, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 04 February 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.