Longitudinal, mixed method study to look at the experiences and knowledge of non melanoma skin cancer from diagnosis to one year

Abstract

BackgroundSkin cancer is the most common type of cancer in humans and the incidence is increasing worldwide. Our objective was to understanding the needs, experiences and knowledge of individuals with Non Melanoma Skin Cancer (NMSC) from diagnosis up until one year.MethodsPatients with NMSC completed questionnaires at diagnosis, treatment, 8 weeks post treatment and 12 months post diagnosis. Body image, psychological morbidity and Quality of Life (QOL) were assessed at each time point, with the exception of QOL that was not assessed at diagnosis. Knowledge of NMSC was assessed at baseline and 8 weeks. A sub-sample of participants was also interviewed to allow a more in-depth exploration of patients’ experiences.Results76 participants completed the initial questionnaire, of which 15 were interviewed. Patients were anxious about a diagnosis of skin cancer, however they were no more depressed or anxious than the general population. QOL significantly improved from diagnosis to 8 weeks and from diagnosis to one year. Knowledge of NMSC was poor and did not improve after treatment. Hairdressers were highlighted as playing an important role in raising awareness and encouraging individuals to seek medical help. Most participants were aware of the need to check their skin for suspicious lesions but were not sure what to look for. At one year participants had forgotten their experience and were not overly concerned about skin cancer.ConclusionThere is a need to raise awareness of the signs and symptoms of NMSC. Information on skin cancer needs to be tailored to the individual both at the start of treatment and during the follow up months, ensuring that participants’ needs and expectations are met. Targeting education at individuals in the community who regularly come into contact with skin should help in early identification of NMSC. This is important since skin cancer caught early is easily treatable and delay in presentation leads to larger and more complex lesions which impacts in terms of increased morbidity and increased health care costs.

Patient awareness and sun protection behaviour following excision of basal cell carcinoma

“…22e24 A qualitative study in the UK found no significant difference in knowledge from diagnosis of NMSC to 8 weeks post treatment. 22 A similar Italian study in treated Squamous Cell Carcinoma patients found skin cancer knowledge to be low. 24 Both of these groups carried out patient interviews which suggested that lack of awareness was a significant reason for delay in presentation for treatment.…”

The needs and experiences of patients with skin cancer: a qualitative systematic review with metasynthesis

“…Only three studies included keratinocyte carcinoma . Two studies included melanoma that had relapsed, two studies included stage I–III melanoma and one study included stage III melanoma .…”

“…Nine studies were conducted in the U.K., [21][22][23][24][25][26][27][28][29] three in the U.S.A. [30][31][32] and two in Australia. [33][34][35] Only three studies included keratinocyte carcinoma.…”

“…[33][34][35] Only three studies included keratinocyte carcinoma. 21,22,32 Two studies included melanoma that had relapsed, 25 studies included stage I-III melanoma 28,31 and one study included stage III melanoma. 35 In two studies, the stage of melanoma was unknown.…”

“…The previous systematic review in 2010 highlighted the need for further research into the needs and experiences of patients with skin cancer. Six years later, a further 12 studies have been published; however, only two of these studies exclusively considered keratinocyte carcinoma . Despite the high incidence rates of keratinocyte carcinoma worldwide, very few studies have directly investigated the psychosocial effects of this cancer and its treatment.…”