Cancer and kidney disease
Previous studies have suggested the frequency and incidence of malignancy is higher in patients with End Stage renal disease on dialysis as well as those who received a renal transplant, when compare to the general populations. Cancer risks were also seen significantly higher in younger ESRD patients. In particular endocrine tumours such as thyroid tumours ( SIR 2.23) and cancers of the urogenital systems ( SIR 3.60). No studies, however have looked at the incidences, risks, prognosis and survival of cancers in the chronic kidney disease population ( pre-dialysis).
The increased risks for cancers may be due to several reasons: chronic infections, previous exposures to immunosuppressive and cytotoxic agents, nutritional deficiencies, altered immune systems as well as underlying hereditary and acquired diseases such as the inherited or acquired cystic diseases of the kidney. Evidence on cancer screening in the ESKD and renal transplant population is insufficient and inadequate. With the significant increased risks of all cancers in the transplant and ESKD population, no RCT has performed to assess the efficiency, adequacy and accuracy of cancer screening in these populations. Clearly, further studies need to be done to address these issues.
The following areas that will be addressed are:
- To describe the cancer risks and incidence in Chronic Kidney disease (CKD) population and compare that to the general population
- Review of clinical cancer screening guidelines in the general population and assess its implications and appropriateness in the renal transplant and end stage kidney disease populations (ESKD)
- Evaluating cancer screening practices among nephrologists and renal transplant physician in the chronic kidney disease (CKD), end stage kidney disease (ESKD) and renal transplant populations
- Investigating and assessing cancer screening test performances in the chronic kidney disease, dialysis and renal transplant population
- Evaluation of the effectiveness of common cancer treatment with CKD as a modifier