According to the latest study set to publish its findings in the upcoming issue of Journal of the American Society of Nephrology, screening male kidney transplant patients for prostate cancer before the transplant is done may be more harmful than beneficial. This is because the screening doesn’t appear to prolong their survival, but instead might interfere with the transplant process.
Screening for prostate cancer whereby prostate specific antigen (SPA) levels are assessed is highly controversial due to the fact that PSA levels may be raised in a variety of disease processes. Furthermore, even in the general population, there are no clear benefits of early treatment interventions for prostate cancer.
At the moment, there are no clear guidelines for prostate cancer screening in patients suffering from kidney diseases and undergoing evaluation for possible kidney transplantation. Nonetheless, kidney transplant centers typically screen candidates for potential malignancies as a way of ensuring that there aren’t any contradictions to receiving a transplant.
For the first time, researchers have demonstrated that prostate cancer screening for patients poised to undergo kidney transplantation is not beneficial at all, and chances are that the procedure may be harmful. Investigators led by Nicole Turgeon, Gerardo Vitiello and Blayne Amir Sayed retrospectively analyzed data on 3782 male patients who were undergoing kidney transplant assessments during a 10-year period, and discovered that:
i). Prostate specific antigen (PSA) screening isn’t associated with improved or better patient survival after the transplantation is complete.
ii). Prostate specific antigen (PSA) screening increased the average wait time to listing and eventually transplantation for candidates below the age of 70 whose PSA showed elevated levels.
iii). Compared to kidney transplant candidates who didn’t undergo the screening, PSA-related candidates registered a reduced likelihood of receiving kidney transplant regardless of the level of their prostate specific antigen.
According to Dr. Turgeon, screening for prostate cancer appeared to delay receiving a kidney transplant yet there was no clear survival benefit. He noted that the screening should be avoided especially for any patient awaiting kidney transplant. Although this is a great step, it is still clear that further studies need to be done for concrete evidence to be found. However, the best that can be done is to do away with prostate cancer screening for any patient awaiting kidney transplant, though on a temporary basis while further studies get underway.
Study co-authors include Sebastian Perez, MSPH, Marla Wardenburg, MD, Christopher Keith, BS, Thomas Pearson, MD, Kenneth Ogan, MD, and Daniel Canter, MD.