[The point about...uremia and cancer]

There have been long-lasting controversies as to whether uremic patients are prone to develop cancer. Recent epidemiological data support a small, but significant increase of various solid tumors, particularly those known to be induced by viruses. Paradoxically, either younger or female patients are the most exposed to the risk of cancer. In addition to factors linked to the underlying renal disease (e.g. analgesic abuse, "chinese herbs" or immunosuppressive drugs), uremia per se can enhance carcinogenesis through many different pathways: retention of various carcinogens; abnormalities of nucleic acids; decreased immune response; metabolic and nutritional changes (hyperhomocysteinemia, iron or selenium depletion...); deleterious effects of oxidative stress secondary to bioincompatibility reactions during dialysis. However, except for the ultrasonographic diagnosis of cystderived renal carcinoma, which has been shown beneficial in the younger patients, there should be no routine cancer screening peculiar to uremic patients.