Skin cancer knowledge and photoprotective practices of organ transplant recipients

Abstract

Background: Long-term use of immunosuppressive medications by organ transplant recipients (OTRs) leads to an increased risk of non-melanoma skin cancers (NMSCs).The objective of this study was to assess photoprotective knowledge and practices among OTRs and to identify predictors of poor sunscreen adherence and barriers to photoprotection. Methods:A written survey was administered to 300 solid OTRs attending the Southern Alberta Transplant Program. Demographics, transplant and NMSC history, ultraviolet radiation (UVR) exposure, photoprotective knowledge and practices, and barriers to implementing photoprotection were collected. Relevant statistical analyses and univariate and multivariable regression models on sunscreen use were performed. Results:One hundred and seventy-nine of the 300 respondents reported not using sunscreen most days despite 79.3% recalling have received photoprotection education. Of the surveyed OTRs, 45.7% reported no barriers to implementing photoprotective practices. On average, respondents scored 74.5% on a commonly used tool to assess photoprotective knowledge (SD 30.6%). In multivariable analyses, older age, male gender, and lack of post-secondary education were associated with lower rates of self-reported sunscreen use. The most commonly patient-reported barriers to photoprotection were "hassle/time consuming" (16.7%) and "sunscreen is uncomfortable or unpleasant" (10.0%).Conclusions: Despite OTRs self-reporting having received sufficient sun-protective knowledge and demonstrating reasonable recollection of photoprotective education on assessment, implementation of sun protection in the studied OTRs remains suboptimal. K E Y W O R D Seducation, non-melanoma skin cancer, photoprotection, sunscreen, transplantation

Comparison of skin cancer awareness and sun protection behaviours between renal transplant recipients and patients with glomerular disease treated with immunosuppressants

“…Due to the paucity of studies focusing on skin cancer risks in patients with GD, we hope that our findings will help fill the gap in the literature. The latter is a contrast to many prior studies on sun protection measures in organ transplant recipients around the world 20‐22,29,30 . Previous studies published in Australia did not include regional transplant recipients who overall have lower education attainment and employment opportunity which may affect patients' awareness of skin cancers and sun protection measures 16,19,26 .…”

The burden of cutaneous disease in solid organ transplant recipients of color

“…Male sex has previously been reported as a risk factor for skin cancer in OTRs 24 . This may relate, in part, to photoprotective behavior and occupational UVR exposure 25,26 …”

Reducingnon‐melanomaskin cancer risk in renal transplant recipients

“…Studies in North America, Europe and Australia have found sun protective measures in SOTRs were suboptimal. [37][38][39] Patient compliance with photoprotective measures, based on observational studies and randomized control trials (RCTs), would improve if education was reinforced after immunosuppressant exposure. [40][41][42][43][44][45][46][47][48][49][50][51]…”