Comparison of Stage at Diagnosis of Cancer in Patients Who Are on Dialysis versus the General Population

Abstract

Results: A total of 1629 patients with ESRD and incident cancer were identified. Overall, the likelihood of nonlocalized stage at diagnosis was not significantly different for patients with ESRD versus the standardized Surveillance, Epidemiology, and End Results general population or matched Medicare control subjects. Stratifying by cancer site, colorectal cancers were significantly more likely to be diagnosed earlier in the ESRD group, whereas prostate cancers were significantly more likely to be diagnosed at a later stage.Conclusions: With the exception of prostate cancer, patients with ESRD are not more likely to present with later stage malignancies compared with the general population.

Epidemiology of cancer in end-stage renal disease dialysis patients: a national cohort study in Taiwan

“…We sought to identify risk factors for cancer in ESRD patients on dialysis and found that being older (≥ 65 years) was one such risk factor, a finding consistent with other studies 2, 6, 7. DM is a risk factor for cancer in the general population; whether DM is associated with a higher incidence of cancer in ESRD patients on dialysis is still being debated.…”

“…However, there are some conflicting data with regard to gender discrepancy. A large international collaborative study 3 reported that the overall risk for cancer was higher in women than in men during dialysis, but other investigations 6, 7 have reported contradictory findings. Thus far, very few studies have examined the survival rate of ESRD patients on long-term renal dialysis for those with various types of cancer 6.…”

Higher risk of malignant neoplasms in young adults with end‐stage renal disease receiving haemodialysis: A nationwide population‐based study

“…The increased risk of cancer among ESRD patients may largely be due to the effects of underlying renal or urinary tract diseases (as in acquired renal cystic disease) and an increased susceptibility to viral carcinogenesis . Dialysis patients frequently have no urinary output, and a lack of urinary tract symptoms might delay the diagnosis of urinary tract malignancies compared to the general population . Acquired cystic disease and prolonged exposure to analgesics and cyclophosphamide are the most common risk factors contributing to the higher incidence of urinary tract malignancies.…”

“…Lymphatic and hematopoietic malignancies vary in aetiology and survival . It has been reported that there are no significant differences in stage at diagnosis for lymphatic and hematopoietic malignancies between dialysis patients and the general population . Because of the high incidence of anaemia and the use of anti‐coagulants, complete blood count tests are usually followed up regularly in dialysis patients.…”

Differences in prostate cancer detection rates according to the level of glomerular filtration rate in patients with prostate specific antigen levels of 4.0-10.0 ng/ml

“…Although indications for prostate biopsies are usually based on tPSA levels ‡ 4 ng ⁄ ml and a positive digital rectal exam, population-based assessments have also suggested that cancer screening occurs less frequently in dialysis patients vs. the general population (7). Many patients with CKD take aspirin or anticoagulants because of underlying diseases such as diabetes or hypertension.…”