Managing cancer risk and decision making after kidney transplantation.
Kidney transplant recipients are at higher risk of cancer at most sites, and cancer after transplantation causes considerable morbidity and mortality. To optimize long-term patient outcomes, clinicians balance the prospect of graft failure and dialysis, with competing risks of diabetes, cardiovascular and cerebrovascular disease and the risk of malignancy. In this paper we critically examine the assumptions underpinning primary prevention, immunization, chemoprevention and screening programs, and highlight considerations when applying evidence to the kidney transplant population, and suggest a clinical research agenda that aims to define a rational approach to managing posttransplant cancer risk.
Webster
A C
AC
School of Public Health, University of Sydney, Westmead Hospital, NSW Australia. angela.webster@gmail.com
Wong
G
G
Craig
J C
JC
Chapman
J R
JR
D003657:Decision Making; D055088:Early Detection of Cancer; D006085:Graft Survival; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000628:therapy*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008495:Medical Oncology / Q000379:methods; D009369:Neoplasms / Q000209:etiology* / Q000517:prevention & control*; D009398:Nephrology / Q000379:methods; D011788:Quality of Life; D012306:Risk; D012307:Risk Factors; D016896:Treatment Outcome