A GLOBAL SURVEY OF SELF-REPORTED CANCER SCREENING PRACTICES BY HEALTH PROFESSIONALS FOR KIDNEY TRANSPLANT CANDIDATES AND RECIPIENTS
Dr NIDA SALEEM1,2,3, Dr WAI H LIM4,5, Associate Professor ANNABELLE WILSON1, Associate Professor JACQUELINE STEPHENS1,2, Professor BILLIE BONEVSKI1, Professor ALLISON JAURE2,6, Professor ARMANDO TEIXEIRA-PINTO2,6, Dr ELEONORA DAL GRANDE1,2, Dr MARTIN HOWELL2,6, Dr FARZANEH BOROUMAND2,6, Dr ANITA VAN ZWIETEN2,6, Dr CHANDANA GUHA2,6, Senior Lecturer NICOLE SCHOLES-ROBERTSON1,2, Dr STEVE CHADBAN6,7, Dr CARMEL HAWLEY8,9, Dr JONATHAN CRAIG1, Dr JEREMY CHAPMAN3, Dr DANYAL HASSAN10, Professor GREG KNOLL11, Dr NAOKA MURAKAMI12, Dr GERMAINE WONG2,3,6
1Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, Australia, 2Centre for Kidney Research, Kids Research Institute, The Children’s Hospital at Westmead, Australia, 3Department of Renal and Transplantation Medicine, Westmead Hospital, Australia, 4Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia, 5Faculty of Health and Medical Science, University of Western Australia, Perth, Australia, 6Sydney School of Public Health, University of Sydney, Australia, 7Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, Australia, 8University of Queensland, Brisbane, Australia, 9Department of Nephrology, Princess Alexandra Hospital, Australia, 10Department of Renal and Transplantation Medicine, Shifa International Hospital, Islamabad, Pakistan, 11The University of Ottawa, Canada, 12Division of Renal Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston,, USA
Background: Cancer is a major cause of morbidity and mortality in kidney transplant recipients. Early detection through screening may allow treatment of cancers at an earlier stage which can improve treatment outcomes. Screening practices are influenced by a range of factors.
Aim: In this study, we aimed to assess transplant health professionals’ reported practices, barriers and the factors influencing their screening practices.
Methods: From March 2023 to February 2024, an online survey was distributed to global transplant health professionals, identified through several societies’ registers. We described their reported screening practices and compared them against the recommended guidelines. Factors that were associated with screening recommendations were assessed using logistic regression modelling.
Results: We received 97 responses, with representation from Australasia, Asia and North America. The majority were nephrologists (70.1%), and most (> 80%) recommended routine breast, colorectal, and cervical cancer screening for both candidates and recipients. About 85% recommended lung cancer screening for higher-risk individuals. Skin cancer screening recommendations varied for transplant candidates (68.6%) and recipients (83.5%). Breast cancer screening reported practices were most concordant with the recommended guidelines, followed by colorectal and skin cancers. Financial constraints (35.4%), lack of post-transplant structured cancer screening systems (51%) and awareness (28.3%) were major reported barriers to screening. Professionals from higher health-resource countries were more likely to advise cancer screening (all cancer types) than those from moderately-resourced countries (odds ratios: between 3.60 and 9.53).
Conclusion: Most health professionals reported recommending cancer screening for transplant candidates and recipients. Their patients’ financial situation and resource inadequacies highly impact cancer screening advice and need attention. Strategies that are low-cost for patients and low-resource need for health services should be explored.
Biography:
Dr. Nida Saleem is a silver medallist at MBBS, a distinguished Adult Nephrologist trained in Pakistan, and is MRCP-certified in Internal Medicine from the Royal College of Physicians, London, UK. Additionally, she is certified in the European Speciality Exam in Nephrology (ESE-Neph). She is a second-year PhD candidate at Flinders University, focusing on cancer screening in transplant recipients. Dr. Saleem is affiliated with Westmead Hospital and the Centre for Kidney Research. Her expertise lies in Kidney Transplantation, Glomerulonephritis, and Peritoneal Dialysis.