Breast Cancer Screening, Incidence, and Mortality in Women Treated With Maintenance Dialysis: A Population-Based Cohort Study in Ontario, Canada

Cancer and cancer-related mortality incidence is approximately 1.5 times higher in patients with kidney failure compared to the age and sex-matched general population. The increased incidence is dependent on the type of cancer. For example, for cancers known to cause kidney dysfunction, such as urinary tract cancer and multiple myeloma, the risk is almost 10 times higher in patients with kidney failure compared to the general population, whereas the incidence of lung cancer, colorectal cancer, and Kaposi’s sarcoma is 2 to 3 times higher among patients with chronic kidney disease. In contrast, the risk of developing breast and prostate cancer is similar between patients with kidney failure and those without kidney disease. The postulated pathogenic mechanisms leading to increased cancer development with kidney dysfunction include alteration in DNA repair, impairment of immune function leading to reduced immune surveillance, reduction in antioxidant defense, chronic inflammation, and cumulative exposure to carcinogenic agents such as long-term immunosuppression.