Screening male kidney transplant candidates for prostate cancer does not improve survival rates

Screening male kidney transplant candidates for prostate cancer may be more harmful than protective because it does not appear to prolong their survival but may interfere with the transplant process, according to a new study. The study, entitled "Utility of Prostate Cancer Screening in Kidney Transplant Candidates," is published in the Journal of the American Society of Nephrology.

There are no guidelines for prostate cancer screening in patients with kidney disease who are undergoing evaluation for kidney transplantation; however, transplant centers generally rigorously screen candidates for potential malignancies to ensure that there are no contraindications to receiving a transplant

Screening for prostate cancer by assessing prostate specific antigen (PSA) levels is controversial because PSA levels may be elevated in a variety of disease processes. Even in the general population, the benefits of early treatment interventions for prostate cancer are unclear.

For the first time, researchers now demonstrate that screening for prostate cancer in kidney transplant candidates is not beneficial, and may actually be harmful. Investigators led by Nicole Turgeon, MD, Blayne Amir Sayed, MD, PhD, from Emory University, and Gerardo Vitiello, MD, from NYU Langone Medical Center, retrospectively analyzed information on 3,782 male patients undergoing kidney transplant evaluations at a single transplant center during a 10-year period. They discovered the following:

PSA screening was not associated with improved patient survival after transplantation.

PSA screening increased the time to listing and transplantation for candidates under 70 years old whose PSA tests indicated elevated levels.

Compared with candidates who were not screened, PSA-screened candidates had a reduced likelihood of receiving a transplant regardless of their PSA level.

“Screening for prostate cancer appears to delay receiving a kidney transplant without a clear survival benefit, and thus should likely be avoided as a general screening tool in the kidney transplant candidate population,” said Turgeon.

Study co-authors include Marla Wardenburg, MD, Sebastian Perez, MSPH, Christopher Keith, BS, Daniel Canter, MD, Kenneth Ogan, MD, and Thomas Pearson, MD.