title: Trends of skin cancer mortality after transplantation in the United States: 1987 to 2013.
abstract: BACKGROUND
  Solid organ transplant recipients are at increased risk of skin cancer, but population-based mortality data are limited.
  
  
  OBJECTIVE
  Mortality and predictors of skin cancer death posttransplantation were investigated.
  
  
  METHODS
  All US organ transplant recipients 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 cancer death 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).
  
  
  CONCLUSIONS
  Limitations of this study included potential underreporting and misclassification of death from skin cancer in the data set.
  
  
  CONCLUSIONS
  Mortality from posttransplantation skin cancer is reported. Older patients, male patients, white patients, and thoracic transplant recipients had increased mortality from skin cancer.
authors.affiliation: Department of Dermatology, University of California at San Francisco, San Francisco, California.
authors.forename: Giorgia L
authors.initials: GL
authors.lastname: Garrett
authors.affiliation: School of Medicine, University of California at San Francisco, San Francisco, California.
authors.forename: Stefan E
authors.initials: SE
authors.lastname: Lowenstein
authors.affiliation: Department of Medicine, University of California at San Francisco, San Francisco, California.
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Singer
authors.affiliation: Department of Medicine, Harvard/Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Steven Y
authors.initials: SY
authors.lastname: He
authors.affiliation: Department of Dermatology, University of California at San Francisco, San Francisco, California. Electronic address: Arrons@derm.ucsf.edu.
authors.forename: Sarah T
authors.initials: ST
authors.lastname: Arron
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015266:Carcinoma, Merkel Cell / Q000401:mortality*; D002294:Carcinoma, Squamous Cell / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality*; D008875:Middle Aged; D009026:Mortality / Q000208:ethnology / Q000639:trends; D016377:Organ Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D012307:Risk Factors; D012737:Sex Factors; D012878:Skin Neoplasms / Q000401:mortality*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: cause of death; cutaneous carcinoma; iatrogenic immunosuppression; mortality outcomes; nonmelanoma skin cancer; organ transplant recipients; rate; solid organ transplantation