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NDT Advance Access originally published online on October 23, 2008
Nephrology Dialysis Transplantation 2009 24(2):647-652; doi:10.1093/ndt/gfn607
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


The uptake of cervical cancer screening by renal transplant recipients

Aisling E. Courtney1, Niall Leonard2, Ciaran J. O’Neill3, Peter T. McNamee1 and Alexander P. Maxwell1

1 Regional Nephrology Unit, Belfast City Hospital, Belfast, BT9 7AB 2 Renal Unit, Ulster Hospital, Dundonald, BT16 1RH 3 Cytopathology Laboratory, Belfast City Hospital, Belfast, BT9 7AB, UK

Correspondence and offprint requests to: Aisling E. Courtney, Regional Nephrology Unit, Level 11, Belfast City Hospital, Lisburn Road, Belfast BT9 7AB, UK. Tel: +44-2890329241; Fax: +44-2890263535; E-mail: aecourtney{at}doctors.org.uk



  Abstract

Background. Renal transplant recipients are at an increased risk of developing cervical cancer compared to women in the general population. At least annual cervical smear screening is currently recommended, but little information is available regarding the actual uptake of such screening.

Methods. All female renal transplant recipients in one United Kingdom region who were alive with a functioning graft were identified. The uptake and results of cervical smear testing over a 10-year period in this cohort were determined.

Results. Of the 173 women eligible for cervical cancer screening, 18 (10%) undertook the recommended number of screening procedures; 56 (32%) had never had a cervical smear performed. The year of transplantation, age at engraftment and the social deprivation status did not significantly influence the uptake of screening (P > 0.05). In those women who were screened, the incidence of smear test abnormalities was 20% in renal transplant recipients compared with 7% in the general population. The cytological findings in the positive smear tests ranged from borderline changes to grade III cervical intraepithelial neoplasia.

Conclusions. The renal transplant population is at higher risk of abnormal cervical cytology, but the uptake of cervical cancer screening is low. The reasons for this low screening rate are unclear, and changes in practice are necessary to improve the uptake of cervical smear testing in women with renal transplants.

Keywords: cancer screening; cervical smear; malignancy; transplant recipients

Received for publication: 6. 6.08
Accepted in revised form: 6.10.08


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