How should the kidney transplant recipient be screened for cancers?
• History and physical examination to exclude disseminated or localized organ involvement by PTLD. High-risk kidney transplant patients (EBV-positive donor with EBV-negative recipient) should be screened the first week post transplant, monthly for 3 to 6 months, then every 3 months until the end of the first year, and then annually.
• Skin examinations by dermatologist (every 6 months in patients at high risk, otherwise yearly)
• Ultrasound or computed tomography scan of the native kidneys annually
• Gynecologic examinations, including Pap test and ultrasound of genitourinary organs annually
• Prostate-specific antigen and digital rectal examination annually in men older than 50 years old or younger in high-risk groups
• Fecal occult blood test annually in men older than 50 years old or younger in high-risk groups
• Abdominal ultrasound and serum alpha fetoprotein levels in carriers of hepatitis B or C virus
• Colonoscopy in individuals, as per general population guidelines
• Mammogram in females, as per general population guidelines
• Cystoscopy in individuals with hematuria, particularly with a history of cyclophosphamide therapy
• Hepatic ultrasound and alpha fetoprotein yearly in patients with cirrhosis
