Cancer after kidney transplant.

Abstract

To the Editor: The recent article by Farrugia et al.1 appears to advocate surveillance for cancer after kidney transplant, which implies screening. However, screening for cancer does not benefit patients with a kidney transplant.2 Consider the three most common cancers in this article: lymphoma, lung, and kidney. One cannot screen for lymphoma because it is too variable in its presentation. The death rate for lung cancer in the UK general population is 60 per 100,000, which is the same as the death rate for lung cancer in the Farrugia et al.1 cohort. Lung cancer is thus not increased in kidney transplant patients. The utility for screening for lung cancer in the general population is controversial.3 As for kidney cancer, screening for kidney cancer in kidney transplant patients is not cost-effective.4 Vigilance for symptoms and better cancer treatment will save lives, not surveillance programs.