Many women with advanced chronic kidney disease (CKD) may be skipping the breast- and cervical-cancer screening they need, even though they are at higher risk of developing cancer, according to a study.
The research, “Patterns and Predictors of Screening for Breast and Cervical Cancer in Women with CKD,” was published in the Clinical Journal of the American Society of Nephrology.
Cancer has an important impact on CKD: Its prevalence in CKD patients is about twice as high as in the general population.
But the higher risk is limited to urinary tract, digestive, breast and viral-related cancer. This is why it is important for women with CKD to get regular breast and cervical cancer screening.
Germaine Wong, PhD, of the University of Sydney, Australia, and her colleagues examined patterns of breast and cervical cancer screening in women, taking into account the stage of their disease and their age.
The team checked Ontario, Canada’s administrative health databases from 2002 to 2013. They found 141,326 women screened for breast cancer and 324,548 for cervical cancer.
The researchers discovered lower screening rates among women who were older, had less income and had other diseases in addition to CKD.
Over a two-year period, the breast-cancer screening rates were: 61% of women without CKD, 54% with CKD stage 3, 37% with CKD stages 4 and 5, and 26% for those with kidney failure who were on dialysis. The patterns were similar for cervical cancer screening over three years.
“These results reflect the inherent healthcare priorities of dialysis patients: older women on dialysis may not have the capacity to deal with the complexity of dialysis management and may have potentially neglected less imminent issues such as preventive healthcare and early cancer detection,” Wong said in a news release. “Given that cancer screening has the potential to improve cancer outcomes, targeted strategies to inform shared decision making in screening is critical.”
“Enhanced coordination of care between nephrologists, general practitioners and women’s healthcare providers may serve to promote cancer screening among women with CKD,” Deidra Crews, MD, ScM, and Waseem Khaliq, MBBS, MPH, said in an accompanying editorial. “Ultimately, however, nephrologists may forge long-term trusting relationships with kidney patients that will afford them the greatest opportunity to engage in shared-decision making together and select the cancer screening plan that is most appropriate for the patient’s individual health status and personal priorities.”