Uptake of cancer screening tests among recipients of solid organ transplantation

Population-based cancer screening recommendations are also suggested for solid organ transplant recipients (SOTR); however, recommendation adherence is unknown. In a population based cohort of SOTR in Ontario between 1997 and 2010, we determined the uptake of breast, cervical, and colorectal cancer screening tests and identified factors associated with up-to-date screening using recurrent event analysis. We identified 4,436 SOTR eligible for colorectal, 2,252 for cervical, and 1,551 for breast cancer screening. Of those, 3,437 (77.5%), 1,572 (69.8%), and 1,417 (91.4%), respectively, were not up-to-date for cancer screening tests during the observation period. However, these rates are likely an overestimate due to the inability to differentiate between tests done for screening or for diagnosis. SOTR with fewer comorbidities had higher rates of becoming screen up-to-date. Assessment by a primary care physician (PCP) was associated with becoming up-to-date with cancer screening (breast RR=1.40, 95%CI: 1.12-1.76, cervical RR=1.29, 95%CI: 1.06-1.57, colorectal RR=1.30, 95%CI: 1.15-1.48). Similar results were observed for continuity of care by transplant specialist at a transplant center. In conclusion, cancer screening for most SOTR does not adhere to standard recommendations. Involvement of PCPs in post-transplant care and continuity of care at a transplant centre may improve the uptake of screening.