Solid organ transplant recipients (SOTRs) are 3 times more likely to develop cancer; however, clinical practice guidelines for cancer screening in this population do not reflect this increased risk, according to a study in the American Journal of Transplantation.1
Researchers at St Michael’s Hospital, Toronto, Ontario, Canada, sought to assess the availability, quality, and consistency of clinical practice guidelines on cancer screening for SOTRs.
For this study, the researchers conducted a systematic search for clinical practice guidelines among bibliographic detabases and gray literature. Guideline quality was assessed using AGREE II. This review included 13 guidelines, along with their supporting evidence.
The review revealed that general recommendations suggested the same level of screening for SOTRs as is recommended for the general population. Although skin cancer screening for SOTRs was most frequently presented, recommendations for screening for breast, cervical, colorectal, or other types of cancers varied considerably between guidelines.
Furthermore, most of the guidelines were developed by transplant specialists and did not include input from oncology specialists, primary care providers, and public health experts. Although some screening guidelines for SOTRs were more specific to this population, the differences were based on a higher incidence reported in the literature rather than on evidence of screening effectiveness.
The researchers report that more studies are needed to inform cancer screening guidelines for SOTRs, and oncologists and cancer screening specialists should be involved in developing these guidelines.
This review focused on solid organ transplants (eg, heart, lung, liver, kidneys) but not hollow organs (eg, intestines) or non-solid tissues (eg, blood, bone marrow).
1. Acuna SA, Huang JW, Scott AL, et al. Cancer screening recommendations for solid organ transplant recipients: a systematic review of clinical practice guidelines. Am J Transplant. 2016 Aug 30. doi: 10.1111/ajt.13978. [Epub ahead of print]