Cancer Screening in Patients Undergoing Maintenance Dialysis: Who, What, and When.

Cancer screening guidelines were developed for the general population with the aim of improving health outcomes through early detection. However, these screening recommendations are not generalizable to patients undergoing maintenance dialysis given that their life expectancy is often less than 5 years. In addition, the performance characteristics of screening tests in patients treated by dialysis may not be the same as in the general population, leading to differences in these tests' sensitivity and specificity in detecting cancer. Survival benefits in patients receiving dialysis may also be tempered by increased risks of curative therapies. Given the uncertainties of cancer screening in patients treated by maintenance dialysis, an individualized approach to cancer screening is warranted. This approach should balance the patient's life expectancy and the potential benefits from screening with its potential costs and harm. The special circumstance of renal cell carcinoma in patients treated by dialysis is also discussed.