Results:

The authors of the study reported that risk of any de novo solid malignancy between years 1 and 5 after transplantation was 10.7%. The leading malignancies were skin cancer (7.0%), nonskin solid cancer (4.0%), and lymphoproliferative disorders (0.9%). There was no temporal difference in the time to development by malignancy type. However, the cumulative incidence of de novo solid malignancy increased from 2000-2005 to 2006-2011 (10.0% vs. 12.4%, p < 0.0001). Survival in patients following de novo malignancy was markedly lower than in patients without malignancy (p < 0.0001). This increase was predominantly owing to the higher incidence of skin cancer in the more recent cohort (8.4% in 2006-2011 vs. 6.4% in 2000-2005, p < 0.0001). The cumulative incidence of nonskin solid cancer was also higher in the more recent era, but the degree of this increase was relatively small (4.5% in 2006-2011 vs. 4.0% in 2000-2005, p = 0.004). The incidence of lymphoproliferative disorders was not significantly different between the two cohorts (0.9% in 2006-2011 vs. 1.0% in 2000-2005, p = 0.1118). Within de novo skin cancer, the incidence of squamous carcinoma increased from 4.0% to 5.9%, and the incidence of basal cell carcinoma increased from 3.1% to 3.5%, both of which were statistically significant (p < 0.05). Within de novo nonskin solid cancer, the most frequent malignancies were prostate cancer (1.4% in 2006-2011 and 1.3% in 2000-2005) and lung cancer (1.0% in 2006-2011 and 1.1% in 2000-2005). Older recipients and patients transplanted in the recent era had a higher risk of de novo malignancy.