Browse the corpus

©2013 UpToDate ® Print Email Suggested guidelines for cancer screening in patients undergoing solid organ transplantation Cancer type Recommendation Breast Women 50 to 69: annual screening mammography with or without clinical breast examination; age 40 to 49: the benefit of screening is less certain, and should be left to the decision of the physician and patient; ≥70 years of age: annual screening is appropriate as long as estimated life exectancy is ≥8 years. Skin Monthly self examination; physician examination annually, with early referral for suspected lesions. Cervical All women ≥18 years old and sexually active girls <18 years old should undergo an annual pelvic examination and PAP smear. Anogenital Yearly physical examination of the anogenital area, including pelvic examination and cytologic studies for women. Insufficient evidence to recommend for or against screening anoscopy and biopsies of anal epithelium. KS/other sarcomas Examination of skin, conjunctivae, and oropharyngeal mucosa annually; patients at higher risk (ethnicity, geographic area of residence or serologic positivity for HHV) may benefit from more frequent screening. Prostate Annual screening with digital rectal examination and PSA recommended for men ≥age 50, if their estimated life expectancy is at least 10 years. If positive family history or African American race, may start annual screening earlier (eg, age 45). Colorectal Starting at age 50: annual FOBT and either sigmoidoscopy every five years or colonoscopy every 10 years*. PTLD Complete history and physical examination every three months, particularly in the first posttransplant year; patients at increased risk of PTLND may benefit from more frequent screening. Lung Not recommended. HCC For patients with chronic hepatitis B or C and cirrhosis, serum AFP and liver ultrasound every 6 to 12 months. Renal cell Screening via cytologic or radiographic means is not recommended, except possibly for patients with a history of analgesic abuse. KS: Kaposi's sarcoma; PSA: prostate specific antigen; HHV-8: human herpesvirus 8; FOBT: fecal occult blood testing; PTLD: posttransplant lymphoproliferative disorder; HCC: hepatocellular cancer. * At some institutions, screening is started at age 40 or five years after transplant, whichever comes first. Modified from: Kasiske BL, et al. J Am Soc Nephrol 2000; 11:S1.