Don’t perform routine cancer screening for dialysis patients with limited life expectancies without signs or symptoms.
Due to high mortality among end-stage renal disease (ESRD) patients, routine cancer screening—including mammography, colonoscopy, prostate-specific antigen (PSA) and Pap smears—in dialysis patients with limited life expectancy, such as those who are not transplant candidates, is not cost effective and does not improve survival. False-positive tests can cause harm: unnecessary procedures, overtreatment, misdiagnosis and increased stress. An individualized approach to cancer screening incorporating patients’ cancer risk factors, expected survival and transplant status is required.
These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.
The American Society of Nephrology (ASN) maintains a Quality and Patient Safety (QPS) Task Force that advances ASN’s commitment to providing high-quality care to patients and to raising awareness of patient safety issues for all professionals administering care to kidney patients. Each of ASN’s 10 advisory groups contributes expertise to the task force to ensure it addresses all areas of nephrology practice, and the society’s president, public policy board and council also provide insights. The QPS task force centered its focus on five items most likely to positively impact and influence optimal patient care. The final list of five items was unanimously approved by the ASN public policy board and council. ASN’s disclosure and conflict of interest policy can be found at www.asn-online.org.
U.S. Renal Data System, American Society of Nephrology, American Society of Transplantation, Archives of Internal Medicine, Seminars in Dialysis.