title: Incidence and risk factors for skin cancer following lung transplantation.
abstract: BACKGROUND
  Relative to other solid-organ transplantations, limited studies characterize skin cancer among lung-transplant recipients.
  
  
  OBJECTIVE
  We sought to assess the cumulative incidence, tumor burden, and risk factors for skin cancer among patients with lung transplantation.
  
  
  METHODS
  Medical records of patients at Mayo Clinic who had undergone lung transplantation between 1990 and 2011 were reviewed (N = 166).
  
  
  RESULTS
  At 5 and 10 years posttransplantation the cumulative incidence was 31% and 47% for any skin cancer, 28% and 42% for squamous cell carcinoma, 12% and 21% for basal cell carcinoma, and 53% and 86% for death, respectively. Four patients died of metastatic squamous cell carcinoma. The cumulative incidence for a subsequent skin cancer of the same type 4 years after an initial skin cancer was 85% and 43% for squamous and basal cell carcinoma, respectively. Increasing age, male gender, skin cancer history, and more recent year of transplantation were associated with increased risk of skin cancer posttransplantation. Sirolimus was not associated with decreased risk, nor did voriconazole show an increased risk for skin cancer.
  
  
  CONCLUSIONS
  Retrospective and tertiary single-center design of the study is a limitation.
  
  
  CONCLUSIONS
  Skin cancers frequently occur in lung-transplant recipients. The risk of subsequent skin cancer is increased substantially in patients who develop a skin cancer after their transplantation.
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Shadi
authors.initials: S
authors.lastname: Rashtak
authors.affiliation: Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.
authors.forename: Ross A
authors.initials: RA
authors.lastname: Dierkhising
authors.affiliation: Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.
authors.forename: Walter K
authors.initials: WK
authors.lastname: Kremers
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Steve G
authors.initials: SG
authors.lastname: Peters
authors.affiliation: Division of General Thoracic Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Cassivi
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota. Electronic address: otley.clark@mayo.edu.
authors.forename: Clark C
authors.initials: CC
authors.lastname: Otley
mesh_terms: D000328:Adult; D000368:Aged; D002280:Basal Cell Carcinoma / Q000453:epidemiology* / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000473:pathology; D047368:Tumor Burden; D055815:Young Adult
keywords: basal cell carcinoma; immunosuppression; incidence; lung transplantation; skin cancer; solid-organ transplantation; squamous cell carcinoma