{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:42:49Z","timestamp":1790188969886,"version":"4.1.0"},"reference-count":34,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"Importance<\/jats:title>Cutaneous squamous cell carcinoma (cSCC) may occur with multiple primary tumors, metastasize, and cause death both in immunocompetent and immunosuppressed patients.<\/jats:p><\/jats:sec>Objective<\/jats:title>To study the rates of second cSCC, metastasis, and death from cSCC in patients with and without organ transplant\u2013associated immunosuppressive treatment.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This population-based, nationwide cohort study used Cancer Registry of Norway data from 47\u202f992 individuals diagnosed with cSCC at 18 years or older between January 1, 1968, and December 31, 2020. Data were analyzed between November 24, 2021, and November 15, 2022.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Receipt of a solid organ transplant at Oslo University Hospital between 1968 and 2012 followed by long-term immunosuppressive treatment.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Absolute rates of second cSCC, metastasis, and death from cSCC were calculated per 1000 person-years with 95% CIs. Hazard ratios (HRs) estimated using Cox proportional hazard regression were adjusted for age, sex, and year of first cSCC diagnosis.<\/jats:p><\/jats:sec>Results<\/jats:title>The study cohort comprised 1208 organ transplant recipients (OTRs) (median age, 66 years [range, 27-89 years]; 882 men [73.0%] and 326 women [27.0%]) and 46\u202f784 non-OTRs (median age, 79 years [range, 18-106 years]; 25\u202f406 men [54.3%] and 21\u202f378 women [45.7%]). The rate of a second cSCC per 1000 person-years was 30.9 (95% CI, 30.2-31.6) in non-OTRs and 250.6 (95% CI, 232.2-270.1) in OTRs, with OTRs having a 4.3-fold increased rate in the adjusted analysis. The metastasis rate per 1000 person-years was 2.8 (95% CI, 2.6-3.0) in non-OTRs and 4.8 (95% CI, 3.4-6.7) in OTRs, with OTRs having a 1.5-fold increased rate in the adjusted analysis. A total of 30\u202f451 deaths were observed, of which 29\u202f895 (98.2%) were from causes other than cSCC. Death from cSCC was observed in 516 non-OTRs (1.1%) and 40 OTRs (3.3%). The rate of death from cSCC per 1000 person-years was 1.7 (95% CI, 1.5-1.8) in non-OTRs and 5.4 (95% CI, 3.9-7.4) in OTRs, with OTRs having a 5.5-fold increased rate in the adjusted analysis.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study, OTRs with cSCC had significantly higher rates of second cSCC, metastasis, and death from cSCC than non-OTRs with cSCC, although most patients with cSCC in both groups died from causes other than cSCC. These findings are relevant for the planning of follow-up of patients with cSCC and for skin cancer services.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamadermatol.2023.2029","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T15:16:08Z","timestamp":1689779768000},"page":"923","source":"Crossref","is-referenced-by-count":24,"title":["Rates of Second Tumor, Metastasis, and Death From Cutaneous Squamous Cell Carcinoma in Patients With and Without Transplant-Associated Immunosuppression"],"prefix":"10.1001","volume":"159","author":[{"given":"Petter","family":"Gjersvik","sequence":"first","affiliation":[{"name":"Institute of Clinical Medicine, University of Oslo, Oslo, Norway"},{"name":"Department of Dermatology, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ragnhild S.","family":"Falk","sequence":"additional","affiliation":[{"name":"Oslo Centre for Biostatistics and Epidemiology, Research Support 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Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inga","family":"Leuckfeld","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten Muri","family":"Boberg","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, University of Oslo, Oslo, Norway"},{"name":"Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marit B.","family":"Veier\u00f8d","sequence":"additional","affiliation":[{"name":"Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trude Eid","family":"Robsahm","sequence":"additional","affiliation":[{"name":"Research Department, Cancer Registry of 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