INTRODUCTION

Organ transplant recipients (OTR) are at increased risk of having both cutaneous and systemic cancer develop. In 1971, Walder et al. were the first to identify that a group of Australian OTR who had received immunosuppression were at increased risk of developing skin cancers. Today, more than 1,000 papers concerning cancer in OTR, many of them including skin cancers, have been published, but very few of the observations have been population based. As a result, the figures on incidence and risks must be interpreted with caution. However, a few population-based studies based on national population-based cancer registries and calendar-period-specific incidence rates in the general population do exist, and they have yielded reliable insight into the magnitude of the problem (Table 21.1). Studies from different countries present a similar picture of increased cancer in OTR, but the type and incidence of tumors varies considerably in different populations depending on geographic and genetic factors as well as transplantation-related factors. The overall increased risk for any type of cancer in OTR has been estimated to be fourfold greater than that in the general population. The most common posttransplantation cancers in Western populations include nonmelanoma skin cancer, lip cancer, non-Hodgkin's lymphoma, cancer of the vulva, vagina, or oral cavity, and anal cancer. In contrast, some of the most common cancers in the general population, breast cancer and prostate cancer, have not been found to have increased incidences in OTR.