PSA Screening May Harm ESRD Patients Awaiting Transplant
Screening not linked to improved patient survival after transplant; may delay time to listing, transplant.
(HealthDay News) -- For patients with end-stage renal disease (ESRD), prostate-specific antigen (PSA) screening may be harmful, according to a study published online in the Journal of the American Society of Nephrology.
Gerardo A. Vitiello, MD, from Emory University in Atlanta, and colleagues examined whether use of PSA-based screening affects time to transplantation and transplant outcomes in patients with ESRD. A total of 3,782 male patients undergoing primary renal transplant evaluation during a 10-year period were retrospectively analyzed. Patients were grouped by age according to the American Urological Association screening guidelines: <55 years, 55 to 69 years, and >69 years.
Overall, 63.6% of candidates underwent screening and 31.7% of candidates received kidney transplants. The researchers found that there was no correlation between PSA screening and improved post-transplant patient survival (P = 0.24). In patients aged <55 and 55 to 69 years who had a positive screening result, PSA screening increased the time to listing and transplantation (P < 0.05). The likelihood of receiving a transplant regardless of the screening outcome was reduced for PSA-screened candidates versus those who were not screened (P < 0.001).
"These data strongly suggest that PSA screening for prostate cancer may be more harmful than protective in renal transplant candidates because it does not appear to confer a survival benefit to these candidates and may delay listing and decrease transplantation rates," the authors write.