Screening for gastroenterological malignancies in new and maintenance dialysis patients

To screen for gastroenterological malignancies in dialysis patients, we used the fecal occult blood test, examined the upper and lower gastrointestinal tract, and used abdominal ultrasonography in 178 patients starting dialysis (171 on hemodialysis and 7 on continuous ambulatory peritoneal dialysis (CAPD)) and 34 patients on maintenance dialysis (27 on hemodialysis and 7 on CAPD). Screening disclosed ten cancers (one esophageal cancer, three gastric cancers, four colorectal cancers, and two hepatocellular carcinomas) in 9 of the patients starting dialysis. Six cancers (one esophageal, three gastric, one colorectal, and one renal) were detected in 5 of the patients on maintenance dialysis. Since an increased incidence of malignancy has been reported in dialysis patients, gastroenterological screening appears to be worthwhile.