A study of malignant tumors in long-term dialysis patients

Futaki, Gen; Shishido, Yoshihiro; Monma, Hiromichi; Ueda, Hitoshi; Taguma, Yoshio; Suzuki, Kazuyuki; Kitamoto, Yasunori; Ishizaki, Makoto; Takahashi, Hisashi; Miura, Kazuhisa; Okazaki, H; Nakamura, Katsuhiro; Fujikura, Yoshihiro; Sekino, Hiroshi; Fukao, Akira; Asaki, Shigeru

doi:10.4009/jsdt1985.19.835

Cited by 3 publications

(6 citation statements)

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“…However, it clearly exists as shown by the males' excess in the present study in con trast to the reverse relationship in the former reports [7][8][9] dealing with subjects mainly in the 1960s and 70s. The risk of malignancy is markedly higher in those studies than in the present study.…”

Section: Discussioncontrasting

confidence: 51%

“…A difference in vulnerability between the sexes has received little attention [7][8][9]. However, it clearly exists as shown by the males' excess in the present study in con trast to the reverse relationship in the former reports [7][8][9] dealing with subjects mainly in the 1960s and 70s.…”

Section: Discussioncontrasting

confidence: 39%

“…Several studies used incidence [2,9,10,17] or mortality [7,8] instead of percentage [3-6, 11] which does not con sider the time of exposure to dialysis. Mortality is the product of incidence and fatality rate.…”

Section: Discussionmentioning

confidence: 99%

“…Patients are referred to leading hospitals as necessary [2] where a more intensive exami nation [9,18] and higher autopsy ratio is expected [II,19], The high incidence among the subjects excluding re ferred patients at our university hospital shows the im portant role of a detection bias. 'Diagnosis rate' of malig nancy in dialysis patients is reported to have increased along with the spread of sonography and computed tom ography [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…An increased risk of malignancy has been found in serial studies of chronic renal failure patients [2][3][4][5][6][7][8][9]; however, other studies have not shown an increased risk [10][11][12][13]. Serial surveys have revealed widely differ ing risk ratios (observed/expected) of malignancy from 0.4-fold by Bush and Gabriel [11] to 21-fold by Miach et al [3].…”

Section: Introductionmentioning

confidence: 99%

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Incidence and Mortality Pattern of Malignancy and Factors Affecting the Risk of Malignancy in Dialysis Patients

Inamoto

Ozaki

Matsuzaki

et al. 1991

Nephron

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A questionnaire study was performed among 23,209 dialysis patients in 589 institutions together with a retrospective study at Keio University Hospital to determine the risk of malignancy and factors affecting the risk ratio in dialysis patients. The incidence and mortality were 1.4-fold and 1.9-fold higher in dialysis patients than the expected rates in the general population. Incidence and mortality were 1.9-fold and 2.6-fold higher in males than in females. The risk ratios were remarkably high in university hospitals, followed by public hospitals. However, there was no significant difference between those in private hospitals and in the general population. The incidence was very high during the first 6 months of dialysis treatment and rather low in the 7th-10th year. The risk ratio of malignancy was higher in younger patients. Beyond the age of 60, the influence of age was greater than that of renal failure. Malignancies of the digestive organs were frequent and constituted 56% of all malignancies. Frequencies of malignancy in the liver, colon, rectum, bladder and kidney were higher than expected, whereas in the pancreas the frequency was lower than expected. Metastasis of malignancy was observed in 30% of the cases. Our study demonstrated a slight to moderate overall increase in the risk of malignancy and a widely differing risk ratio of malignancy by organ involved, sex, age, hospital group, epidemiological index and length of dialysis treatment in a large single racial population of maintenance dialysis patients.

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Section: Discussioncontrasting

confidence: 51%

Section: Discussioncontrasting

confidence: 39%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Incidence and Mortality Pattern of Malignancy and Factors Affecting the Risk of Malignancy in Dialysis Patients

Inamoto

Ozaki

Matsuzaki

et al. 1991

Nephron

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Cost-effectiveness of Cancer Screening in End-Stage Renal Disease

Ad²,

Wf³

et al. 1996

Arch Intern Med

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These analyses suggest that routine cancer screening in the population with ESRD is a relatively inefficient allocation of financial resources. Direction of funds toward improving the quality of dialysis could attain such an objective at substantially lower cost. Furthermore, these findings highlight the importance of competing risks as a consideration in the evaluation of screening strategies and other interventions targeted to patients with ESRD and to other populations with chronic diseases associated with reduced survival.

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