Trends of skin cancer mortality after transplantation in the United States: 1987 to 2013

Background Solid organ transplantrecipients are at increased risk of skin cancer, but population-based mortality data are limited. Objective Mortality and predictors of skin cancerdeath posttransplantation were investigated. Methods All US organ transplantrecipients between 1987 and 2013, identified through the Organ Procurement and Transplantation Network Standard Transplant Analysis and Research file, were included. Mortality and hazard ratios (HR) were calculated for the overall population and patient subgroups. Results The overall mortality was 5308 per 100,000 person-years and the skin cancer–specific mortality was 35.27 per 100,000 person-years. Risk factors associated with skin cancerdeath included thoracic versus abdominal transplantation (HR 2.90, 95% confidence interval [CI] 2.52-3.34), age over 50 years (HR 2.86, CI 2.43-3.38), white race (HR 6.29, CI 4.63-8.53), and male sex (HR 1.85, CI 1.57-2.19). Mortality was highest for malignant melanoma (mortality of 11.48), followed by squamous cell carcinoma (mortality of 4.94) and Merkel cell carcinoma(mortality of 4.59). Limitations Limitations of this study included potential underreporting and misclassification of death from skin cancerin the data set. Conclusion Mortality from posttransplantation skin canceris reported. Older patients, male patients, white patients, and thoracic transplant recipients had increased mortality from skin cancer.