Abstract: FR-PO566
Cancer Screening in ESRD Patients
Session Information
- Physical Activity, Body Composition, Metabolism: Clinical
October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Sundararajan, Anusha, Yale New Haven Health Bridgeport Hospital, Bridgeport, Connecticut, United States
- Kana kadayakkara, Deepak, Yale New Haven Health Bridgeport Hospital, Bridgeport, Connecticut, United States
- Buller, Gregory K., Yale New Haven Health Bridgeport Hospital, Bridgeport, Connecticut, United States
Background
As primary care physicians, we order health maintenance investigations as part of preventive work up which include cancer screening tests. ESRD patients form a special subset of population where regular cancer screening guidelines should not be applied as mortality is higher. The 2012 ASN ‘choosing wisely’ campaign recommended against regular cancer screening in ESRD patients. We initiated a project in our institution to assess the frequency of cancer screening tests- with focus on colorectal cancer screening in our ESRD population.
Methods
We did a retrospective study which included ESRD patients on hemodialysis ( based on ICD codes) from a single center from 2012-2017 and excluded patients who had already received transplant or had prior malignancy. We had a total of 298 patients.
Results
Among the total 298 patients, 188 patients were between 45-75 year age group- out of which 96 patients (51%) underwent colonoscopy; out of 96 patients who underwent colonoscopy, 36 (37.5 %) were not transplant candidates and 16 (16.6%) died within the next 5 years. We also calculated Charlson comorbidity index of the patients to assess their 10 year survival likelihood.
Conclusion
Although patients who were undergoing transplant evaluation and patients with higher life expectancy had higher screening probability, the above numbers suggest that overscreening is still present. Hence, more individualized decision making including transplant likelihood and overall comorbidities of patients have to be considered before ordering cancer screening tests to avoid unnecessary cost and patient burden. These results can also help modify current practice- Providers can be alerted by EMR in ESRD population before ordering cancer screening tests to check if they will really benefit from them.