Colorectal cancer after kidney transplantation – risk factors and the need for prevention

Abstract

Kidney transplantation (KT) in patients with chronic kidney disease is considered a method of renal replacement therapy offering the longest and most comfortable survival possible. Kidney transplantation reduces the risk of multiple complications associated with chronic dialysis, as well as allows patients after transplantation of this organ for full participation in family and social life. However, like any other treatment modality, kidney transplantation has its limitations. These are primarily associated with the need for chronic immunosuppressive therapy. It was shown that chronic immunosuppression increases the risk of cancer. Skin cancers are the most common immunosuppression-related neoplasms. Also, the risk of solid organ cancers is several times higher after kidney transplantation compared to the general population. Cancer is one of the leading causes of mortality in kidney graft recipients. This is due to its insidious and aggressive course in this patient population and the frequent need to modify anticancer therapy. In this paper, we discuss the increased incidence of colorectal cancer (CRC) in patients after kidney transplantation, differences in the course of the disease, as well as its potential prevention, based on the available literature and our own experience. Based on our analysis, we postulate the need for strict recommendations unified for all transplantation centres, regarding oncological surveillance for early detection of colorectal cancer in patients after kidney transplantation.