Which of the following patients of a primary care nurse practitioner would not require extra screening for cancer?

Which of the following patients of a primary care nurse practitioner would not require extra screening for cancer?
A 51-year-old woman whose grandmother died of breast cancer
A 48-year-old man who takes immunosuppressant drugs following a kidney transplant
A 50-year-old male who is obese and has a low-fiber, high-fat diet
A 38-year-old female with Down syndrome and congenital scoliosis