Background.The present study evaluates the effects of long-term immunosuppression after cardiac transplantation on the risk for adenomatous polyps.Methods.The endoscopic procedures performed at LDS and University Hospitals in cardiac transplant recipients were reviewed and compared with results from a previously studied control group.Results.A total of 123 endoscopic procedures were performed in 98 heart transplant patients (59% for cancer screening and 41% for gastrointestinal complaints). Eighty-five percent of patients were male and 15% were female; their mean age was 57 years. In the group <3 years posttransplant, adenomatous polyps were present in 25%, hyperplastic polyps were present in 10%, and synchronous lesions in 3 patients. In the group >3 years posttransplant, adenomatous polyps were present in 16% hyperplastic polyps were present in 22%, and synchronous lesions in were evident in 3 patients. No significant difference with results from a previously studied control group.Conclusions.Long-term immunosuppression does not increase the risk for adenomatous polyps of the colon.