Blood services around the world face increasing challenges in recruiting voluntary blood donors. With increasing donor restrictions and ageing populations, it is essential to look for any existing restrictions that may be relaxed in the light of currently available evidence. We propose that one such restriction is the exclusion of blood donors with a history of a malignancy. Most blood services apart from the United States and Australia continue the historical precaution of permanently excluding donors with a history of cancer, despite the absence of any convincing reports of cancer transmission among the millions of allogeneic blood transfusions performed since the advent of blood banking. In 2007, workers in Scandinavia published convincing data from the SCANDAT (Scandinavian Donations and Transfusions) database that showed no increase in cancer risk among recipients of blood from "precancerous" donors (ie, donors who were later diagnosed with cancer within 5 years of donating) vs recipients of blood from other donors. This review aims to reconcile this finding with other data available in the published literature that is pertinent to the risk of transmitting cancer via blood transfusion, with a view to establishing that there is now sufficient evidence to support the acceptance of carefully selected blood donors with a history of malignant disease.
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