Targeting Screening Mammography According to Life Expectancy Among Women Undergoing Dialysis

Abstract

Screening mammography rates are appropriately low among women undergoing dialysis because the 5-year survival rate is low. Screening is being targeted to women who are healthier and live longer. However, targeting could be improved by increasing screening in the few women undergoing dialysis with substantial life expectancies while decreasing screening in most women undergoing dialysis who live less than 5 years.

Breast cancer screening in women with chronic kidney disease: the unrecognized effects of metastatic soft-tissue calcification

“…The main reason is that some investigators have questioned the benefit of cancer screening in this population, given that life expectancy is decreased and highly variable. [4][5][6] Other authors, however, have suggested that cancer screening should be provided to women with ESRD who are younger (e.g. <50 years, according to one study 4 ), those with no major cardiovascular complications, or those whose calculated life expectancy is greater than 5 years.…”

“…[4][5][6] Other authors, however, have suggested that cancer screening should be provided to women with ESRD who are younger (e.g. <50 years, according to one study 4 ), those with no major cardiovascular complications, or those whose calculated life expectancy is greater than 5 years. 4,7 As the life expectancy of women with ESRD continues to increase, the ideal group of women eligible to receive mammography screening is also increasing.…”

“…<50 years, according to one study 4 ), those with no major cardiovascular complications, or those whose calculated life expectancy is greater than 5 years. 4,7 As the life expectancy of women with ESRD continues to increase, the ideal group of women eligible to receive mammography screening is also increasing. In the US alone, this group includes thousands of women each year.…”

Benefits and Harms of Screening Mammography by Comorbidity and Age: A Qualitative Synthesis of Observational Studies and Decision Analyses

“…After excluding studies with participants whose average age was less than 65 years, those that did not evaluate breast cancer or mammography screening, those that evaluated outcomes other than benefits or harms of screening, and those that did not report on comorbidity, there were 21 remaining studies published between 1980 and 2013, 3,15,17,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] with one article in the process of publication at the time of the literature search, which has since been published. 40 Reviews of the full texts of these studies resulted in the exclusion of 14 studies, 3,17,[23][24][25][26][27][28][29][30][31][32][33][34] leaving 7 studies 15,[35][36][37][38][39][40] (Fig. 1).…”

Preventive health care in chronic kidney disease and end-stage renal disease

“…121 Screening mammography and routine pap smears should, therefore, be offered preferentially to those whose life expectancy is at least 5 years and to those at high risk. 122 Despite the increased prevalence of malignancy among patients with ESRD, 70 routine cancer screening is cost inefficient relative to survival time gained for this population as a whole. 119,123 Cost analysis of cancer screening specifically for patients with CKD or ESRD whose life expectancy when receiving dialysis exceeds 5 years has not been performed.…”