Prostate cancer screening and treatment in the transplant population: current status and recommendations.
OBJECTIVE
We reviewed the current status of and recommendations for prostate cancer screening and treatment in the solid organ transplant population.


METHODS
We performed a MEDLINE search to identify published data regarding prostate cancer screening, risk, treatment and outcomes in the solid organ transplant population. The literature was reviewed and summarized.


RESULTS
Most data regarding outcomes of prostate cancer treatment in the transplant population are limited to case reports and small series, and primarily involve renal insufficiency. It does not appear that the development or natural history of prostate cancer is significantly affected by organ failure or subsequent transplantation. Thus, prostate specific antigen testing and screening protocols can be extrapolated from the general population. However, the balance of comorbid diseases and estimated limitations in life expectancy must be carefully considered, and emphasis should be placed on risk assessment. Prostatectomy appears to be feasible with outcomes comparable to those in the non-transplant population, while data regarding the use of radiation therapy are limited.


CONCLUSIONS
The expansion of organ transplant criteria, including older donors and recipients, combined with improved allograft survival has enhanced the relevance of prostate cancer screening and treatment in this group. Greater awareness of the issues surrounding prostate cancer incidence, detection and natural history should promote improved data collection, screening and treatment of prostate cancer in the transplant population.
Breyer
Benjamin N
BN
Department of Urology and Surgery, Division of Transplant Surgery, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California, USA.
Whitson
Jared M
JM
Freise
Christopher E
CE
Meng
Maxwell V
MV
D000328:Adult; D017677:Age Distribution; D055088:Early Detection of Cancer; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D016030:Kidney Transplantation; D017093:Liver Failure / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008403:Mass Screening / Q000592:standards* / Q000639:trends; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects / Q000379:methods*; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D018570:Risk Assessment; D017678:Sex Distribution; D016019:Survival Analysis
D017430:Prostate-Specific Antigen