http://orcid.org/0000-0001-5287-6096
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Abstract
Background: Cancer is currently one of the most important factors affecting the long-term health and survival of heart transplant patients.
Material and methods: We calculated the standardized incidence ratios (SIR) for different cancer sites and the cancer-specific standardized mortality ratio (SMR) by linking a cohort of 479 adult heart transplant recipients transplanted in 1985–2014 (4491.6 person-years of follow-up) with data from the national Finnish Cancer Registry until the end of 2015, and with the data from the Statistics Finland’s national registry of causes of death.
Results: A total of 267 cancers occurred in 143 patients (SIR 6.0; 95% confidence interval (CI) 5.3–6.7). The SIR for overall cancer was considerably higher for men (SIR 6.7; 95% CI 5.9–7.5) than for women (1.4; 95% CI 0.6–2.6). Most frequent cancers were non-melanoma skin cancers (basal cell carcinoma 83 cases, squamous cell skin cancer (SCC) 56 cases), followed by Non-Hodgkin lymphoma (NHL) (36 cases), lung cancer (17), cancer of prostate (16) and cancer of kidney (12). SIRs were highest for SCC (51.9; 95% CI 39.2–67.4), lip cancer (47.4; 95% CI 19.1–97.7), cancer of tongue (26.3; 95% CI 7.2–67.4), and NHL (25.7; 95% CI 18.0–35.6). For most cancers, SIRs increased steadily by time since transplantation. Cancer mortality was three times higher for heart transplant recipients than for the population (SMR 3.1; 95% CI 2.1–4.1).
Conclusions: Both cancer incidence and mortality are remarkably increased after heart transplantation, with the relative incidence most elevated for SCC, lip and other oral cancers, and for NHL.
Disclosure statement
No potential conflict of interest was reported by the authors.