Study Suggests Colon Cancer Overscreening in Dialysis Patients
Patients in the lowest quartile of mortality risk were more likely to be screened for colon cancer than those in the highest quartile.
(HealthDay News) — For patients on dialysis, colon cancer screening is more likely among those with the lowest risk of mortality, according to a study published online in the Journal of the American Society of Nephrology.
Christopher A. Carlos, MD, from the University of California in San Francisco, and colleagues examined the frequency of colon cancer screening among patients on dialysis in a cohort study of 469,574 Medicare beneficiaries aged ≥50 years who received dialysis.
The researchers found that 11.6% of patients received a colon cancer screening test over a median follow-up of 1.5 years (57.9 tests per 1000 person-years). The incidence rates were 27.9, 0.6, and 29.5 per 1,000 person-years for colonoscopy, flexible sigmoidoscopy, and fecal occult blood test, respectively. Compared with patients in the highest quartile of mortality risk, those in the lowest quartile were more likely to be screened (hazard ratio, 1.53; 65.1 vs 46.4 tests per 1,000 person years), representing a 33% increased rate of testing. Patients most likely to receive a transplant were also more likely to be screened than those least likely to receive a transplant (hazard ratio, 1.68).
"Colon cancer screening is being targeted toward dialysis patients at lowest risk of mortality and highest likelihood of transplantation, but absolute rates are high, suggesting overscreening," the authors write.
- Carlos CA, McCulloch CE, Hsu C, et al. Colon Cancer Screening among Patients Receiving Dialysis in the United States: Are We Choosing Wisely? J Am Soc Nephrol. 23 March 2017. doi: 10.1681/ASN.2016091019