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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Malignancy is the third leading cause of death among hemodialysis patients in Japan and is recognized as an important prognostic factor. Although the incidence of malignancy is higher in hemodialysis patients than in the general population, and cancer screening is therefore recommended, there remains insufficient evidence regarding the effectiveness of specific screening tests in this population. In this study, we investigated the detection rate of malignancies at the initiation of maintenance hemodialysis in patients with end-stage renal disease and evaluated the usefulness of cancer screening in this setting. We conducted a single-center retrospective study of patients who initiated hemodialysis between January 2022 and December 2024 to address two key questions: (i) whether the severity of anemia and the presence of iron deficiency are indicative of malignancy at the time of dialysis initiation, and (ii) whether performing computed tomography (CT) and upper/lower gastrointestinal (GI) endoscopy at that time is effective for malignancy screening.
In this retrospective cohort study, we reviewed the medical records of patients who initiated hemodialysis during the study period, excluding those receiving temporary hemodialysis. Clinical and laboratory parameters, comorbidities, cancer screening status, and treatment details were collected. Malignancy was defined as clinically or pathologically confirmed cancer.
Group comparisons were performed using the chi-square or Fisher’s exact test for categorical variables and the t-test or Mann–Whitney U test for continuous variables. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. A p-value < 0.05 was considered statistically significant.
A total of 86 patients were included. Among them, 80 (93.0%) underwent CT, 57 (66.3%) upper endoscopy, and 24 (27.9%) lower endoscopy. Malignancy was identified in 4 patients (4.7%). There were no significant associations between malignancy and anemia treatment (OR = 0.78, 95% CI 0.08–8.03, p = 1.00) or iron use (OR = 7.25, 95% CI 0.69–382.6, p = 0.12).
Transferrin saturation (TSAT) data were available for 84 patients. The mean hemoglobin (Hb) level was 9.35 ± 1.83 g/dL in the malignancy group and 9.71 ± 1.34 g/dL in the non-malignancy group; mean TSAT was 37.67 ± 14.19% and 27.89 ± 13.99%, respectively. No significant differences were observed (Hb: p = 0.573; TSAT: p = 0.228).
The overall standardized incidence ratio (SIR) for cancer was 2.45 (95% CI 0.67–5.02, p = 0.12). By sex, the SIRs were 1.26 (95% CI 0.14–4.55, p = 0.47) in men and 5.96 (95% CI 0.67–21.6, p = 0.045) in women. Site-specific risks were elevated for colorectal cancer (SIR 7.76, 95% CI 0.87–28.0, p = 0.028), with significantly higher SIRs in women for kidney cancer (SIR 107.5, 95% CI 2.7–598.7, p = 0.048) and pancreatic cancer (SIR 67.3, 95% CI 1.1–239.5, p = 0.038).
In this cohort, four malignancies were detected through CT and endoscopic screening, representing a relatively high incidence at the time of hemodialysis initiation. No significant associations were found between malignancy and anemia treatment or iron status. Hb and TSAT levels did not distinguish renal anemia from malignancy-related anemia.
Although the overall cancer incidence was not significantly elevated, colorectal cancer was significantly increased overall and among men. In women, overall cancer, kidney cancer, and pancreatic cancer demonstrated significantly elevated SIRs.
Despite wide confidence intervals and the possibility of chance findings, the magnitude of SIRs and the survival of all four detected cases as of October 2025 suggest potential clinical benefit of malignancy screening at hemodialysis initiation. Incomplete uptake of CT and endoscopic evaluations may have led to underestimation. Extended follow-up and improved adherence may further clarify the utility of such screening. Larger, multicenter studies are warranted to validate these findings and establish evidence-based screening strategies.
