2275 THE IMPACT OF SCREENING GUIDELINES IN THE PROPORTION AND MORTALITY OF DE NOVO MALIGNANCY IN A SINGLE CENTRE COHORT OF 2016 RENAL TRANSPLANTS

INTRODUCTION AND OBJECTIVES: De novo malignancy in transplant recipients is one of the most common long-term causes of death. It was not before 2000 that the American Society of Transplantation developed for the first time guidelines for oncological screening in renal transplanted patients. The aim of this study is to report, in a single centre cohort of 2016 patients, the relative frequency of de novo cancer and the potential impact on mortality of screening guidelines for malignancy in renal transplant recipients. METHODS: A retrospective analysis of our prospective database of 2016 patients submitted to allograft transplantation between January 1983 and June 2011 was performed to retrieve data of patients developing de novo tumors. Since a systematic screening schedule for transplanted patients was only implemented in our centre in December 2001, we have compared epidemiological and clinical data from pre and post-2002. Mann-Whitney and Pearson’s chi-square tests were used for statistical comparisons of continuous and categorical variables, respectively. RESULTS: Forty-five de novo malignancies in 43 patients were diagnosed before December 2001 (pre-screening) and 94 de novo malignancies in 75 patients from January 2002 till June 2011(postscreening). The median age at diagnosis in the pre and post-screening periods was 52.5 (IQR:39-59) and 57 (IQR:49-62) (p 0.01) years respectively. Twenty and 23 females with de novo malignancy were diagnosed in the pre and post-screening period. Table 1 shows the relative frequency and table 2 the mortality rates according to tumor types. CONCLUSIONS: There is an increase in the relative frequency of the novo cutaneous tumors in the post-screening era, although not statistically significant. There is also a tendency to an overall reduced mortality in the majority of tumors, which may indicate early diagnosis in the post-screening era. The adoption of screening guidelines for cancer in renal transplant recipients is an important strategy in this high risk population.