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Am J Transplant. 2017 Sep;17(9):2434-2443. doi: 10.1111/ajt.14272. Epub 2017 May 9.

Uptake of Cancer Screening Tests Among Recipients of Solid Organ Transplantation.

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Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
Institute of Health, Policy Management, and Evaluation, University of Toronto, Toronto, Canada.
Institute for Clinical Evaluative Sciences, Toronto, Ontario.
Sunnybrook Academic Family Health Team, Department of Family and Community Medicine, University of Toronto, Toronto, Canada.
Division of Nephrology, University Health Network, Toronto, Canada.
Department of Surgery, University of Toronto, Toronto, Canada.


Population-based cancer screening recommendations are also suggested for solid organ transplant recipients (SOTR); however, recommendation adherence is unknown. In a population-based cohort of SOTR in Ontario between 1997 and 2010, we determined the uptake of breast, cervical, and colorectal cancer screening tests and identified factors associated with up-to-date screening using recurrent event analysis. We identified 4436 SOTR eligible for colorectal, 2252 for cervical, and 1551 for breast cancer screening. Of those, 3437 (77.5%), 1572 (69.8%), and 1417 (91.4%), respectively, were not up-to-date for cancer screening tests during the observation period. However, these rates are likely an overestimate due to the inability to differentiate between tests done for screening or for diagnosis. SOTR with fewer comorbidities had higher rates of becoming screen up-to-date. Assessment by a primary care provider (PCP) was associated with becoming up-to-date with cancer screening (breast relative risk [RR] = 1.40, 95% confidence interval [CI]: 1.12-1.76, cervical RR = 1.29, 95% CI: 1.06-1.57, colorectal RR = 1.30, 95% CI: 1.15-1.48). Similar results were observed for continuity of care by transplant specialist at a transplant center. In conclusion, cancer screening for most SOTR does not adhere to standard recommendations. Involvement of PCPs in posttransplant care and continuity of care at a transplant center may improve the uptake of screening.


cancer/malignancy/neoplasia; clinical research/practice; complication; guidelines; health services and outcomes research; malignant; organ transplantation in general; primary care; registry/registry analysis

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