Choosing Wisely:

Don’t perform routine cancer screening for dialysis patients with limited life expectancies without signs or symptoms.

Rationale and Comments: Due to high mortality among end-stage renal disease patients, routine cancer screening—including mammography, colonoscopy, prostate-specific antigen, 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.
Sponsoring Organizations:
  • American Society of Nephrology
  • Sources:
  • American Society of Nephrology
  • Disciplines:
  • Preventive Medicine
  • Nephrologic
  • Oncologic
  • References: • U.S. Renal Data System.
    • American Society of Nephrology
    • American Society of Transplantation
    • Archives of Internal Medicine
    • Seminars in Dialysis

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