title: Significantly higher incidence of skin cancer than other malignancies in patients after heart transplantation. A retrospective cohort study in the Czech Republic.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Dermatovenereology, 2nd Faculty of Medicine, Charles University in Prague and Bulovka Hospital, Prague, Czech Republic.|Department of Epidemiology, 2nd Faculty of Medicine, Charles University in Prague.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Secnikova
authors.affiliation: Department of Epidemiology, 2nd Faculty of Medicine, Charles University in Prague.
authors.forename: Dana
authors.initials: D
authors.lastname: Gopfertova
authors.affiliation: Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague.
authors.forename: Lenka
authors.initials: L
authors.lastname: Hoskova
authors.affiliation: Department of Dermatovenereology, 2nd Faculty of Medicine, Charles University in Prague and Bulovka Hospital, Prague, Czech Republic.
authors.forename: Jana
authors.initials: J
authors.lastname: Hercogova
authors.affiliation: Department of Dermatovenereology, 2nd Faculty of Medicine, Charles University in Prague and Bulovka Hospital, Prague, Czech Republic.|Department of Epidemiology, 2nd Faculty of Medicine, Charles University in Prague.
authors.forename: Martina
authors.initials: M
authors.lastname: Dzambova
authors.affiliation: Department of Dermatovenereology, 2nd Faculty of Medicine, Charles University in Prague and Bulovka Hospital, Prague, Czech Republic.
authors.forename: Anna
authors.initials: A
authors.lastname: Jirakova
authors.affiliation: Department of Dermatovenereology, 2nd Faculty of Medicine, Charles University in Prague and Bulovka Hospital, Prague, Czech Republic.|Department of Epidemiology, 2nd Faculty of Medicine, Charles University in Prague.
authors.forename: Lucie
authors.initials: L
authors.lastname: Rajska
authors.affiliation: Department of Dermatovenereology, 2nd Faculty of Medicine, Charles University in Prague and Bulovka Hospital, Prague, Czech Republic.
authors.forename: Filip
authors.initials: F
authors.lastname: Rob
authors.affiliation: Department of Epidemiology, 2nd Faculty of Medicine, Charles University in Prague.
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Smerhovsky
mesh_terms: D002280:Basal Cell Carcinoma / Q000453:epidemiology*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D018153:Czech Republic / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000009:adverse effects* / Q000706:statistics & numerical data; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000453:epidemiology*
chemical_list: D007166:Immunosuppressive Agents
keywords: heart transplantation; immunosuppression; skin cancer