Journal Article

Cancer screening and life expectancy of Canadian patients with kidney failure

Sahar Kajbaf, Graham Nichol and Deborah Zimmerman

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 17, issue 10, pages 1786-1789
Published in print October 2002 | ISSN: 0931-0509
Published online October 2002 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/17.10.1786
Cancer screening and life expectancy of Canadian patients with kidney failure

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Background. Patients with end‐stage renal disease (ESRD) have at least the same prevalence of breast and cervical cancer but a reduced life expectancy compared with the general population. Whereas cancer screening has been found to be effective in the general population, competing risks in ESRD patients may obviate any screening benefit in this population. The purpose of this study was to determine if patients with ESRD benefit, in terms of life expectancy, by screening for breast and cervical cancer.

Methods. The ESRD mortality data from the Canadian Organ Replacement Registry was combined with North American statistics for breast and cervical cancer mortality, incidence, and screening efficacy for 40‐, 60‐, and 70‐year‐old women. A validated method of calculating life expectancy, the declining exponential approximation of life expectancy (DEALE), was used to estimate the average life expectancy with and without screening. The benefit of screening is then the estimated difference in the life expectancy with and without mammography or PAP smears.

Results. Without screening, the maximum reduction in life expectancy would be 12 days for 60‐year‐old women with breast cancer. The maximum calculated benefit from screening was an increase in life expectancy of only 3 days with PAP smears for 60‐year‐old women.

Conclusions. Breast and cervical cancer screening, in women with ESRD, is not associated with as large a gain in life expectancy as for women of the general population. This conclusion does not necessarily apply to the individual woman with multiple risk factors for breast or cervical cancer and few comorbidities.

Keywords: breast neoplasms; cancer screening; cervix neoplasms; life expectancy; renal failure

Journal Article.  2279 words. 

Subjects: Nephrology

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