Immunosuppression, Race, and Donor-Related Risk Factors Affect De novo Cancer Incidence Across Solid Organ Transplant Recipients

Malignancy risk varies across SOT groups and correlates with the number of immunosuppressant drugs used. Mammalian target of rapamycin inhibitor-based immunosuppression seems protective against nonmelanoma skin cancer only. Cancer risk may be improved by minimizing the number of immunosuppressants and the degree of immunosuppression used, particularly in at-risk patients. Increased age, male sex, previous malignancy, and white race are characteristics that should prompt heightened vigilance in cancer screening by transplant physicians and internists who follow this patient population.