TABLE 3.

Screening Recommendations for Malignancies in Liver Transplant Recipients

Skin cancer	Annual dermatologic examination, especially in patients with history of skin cancer or actinic skin damage, patients who received a transplant for alcoholic liver disease, and white patients
Posttransplant lymphoproliferative disorders	High index of suspicion in patients presenting with category B symptoms, weight loss, or lymphadenopathy, especially in EBV-seronegative patients
Colon cancer	Strict adherence to guidelines for colorectal cancer screening in average-risk population; annual colonoscopy in patients who received a transplant for primary sclerosing cholangitis and/or inflammatory bowel disease with random surveillance biopsies
Cervical cancer	Strict adherence to pelvic examination and PAP smear recommendations for the general population, in accord with American Cancer Society recommendations
Lung cancer	Annual chest x-ray for high-risk OLT recipients, including smokers and patients who received a transplant for alcoholic liver disease
Oropharyngeal/laryngeal cancer	Annual otolaryngology evaluation for high-risk OLT recipients, including smokers and patients who received a transplant for alcoholic liver disease
Breast cancer	Annual mammogram starting at age 40, in accord with American Cancer Society recommendations
Prostate cancer	Annual PSA evaluation starting age 50, as for the general population in accord with the American Cancer Society recommendations

EBV= Epstein-Barr virus; OLT = orthotopic liver transplant; PAP = Papanicolaou; PSA = prostate-specific antigen.