Skin Cancer Education May Improve Sun Protection Practices Among Organ Transplant Recipients

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The likelihood of wearing long sleeves and hats increased more than did the likelihood of applying sunscreen.
The likelihood of wearing long sleeves and hats increased more than did the likelihood of applying sunscreen.

The use of multiple sun protection behaviors among organ transplant recipients increased after their participation in the Skin Tumors and Allograft Recipients (STAR) Study: a retrospective cohort study among kidney and liver transplant recipients at high risk for skin cancer that was conducted in Brisbane, Australia. Results of the study were published in JAMA Dermatology.

Patients were enrolled in the STAR study from November 2012 to May 2016. The investigators surveyed the organ transplant recipients' use of sunscreen, hats, and/or long sleeves when outdoors. The use of multiple sun protection measures was defined as the use of 2 or more of these measures more than 50% of the time when the individual was outdoors. Dermatologists conducted total body skin cancer examinations of the participants.

A total of 225 participants were enrolled in the study. All but 1 of the organ transplant recipients (n=224) were followed for 15 months or more after enrollment (mean follow-up time, 36±5 months). Patients who used multiple sun protection measures at baseline (n=122) were significantly more likely than patients who did not use multiple measures (n=103) to have fair complexions (68% [82 of 122] vs 50% [51 of 103], respectively; P =.01); to have been born in Australia (84% [102 of 122] vs 72% [74 of 103], respectively; P =.03); to have undergone annual skin cancer screening over the past 5 years (64% [78 of 122] vs 39% [40 of 103], respectively; P <.001); and to have undergone prior skin cancer excision (69% [84 of 122] vs 54% [56 of 103], respectively; P =.03).

After adjustment for the above variables, the odds of using multiple sun protection measures increased more than 4-fold between study entry and study exit (odds ratio [OR] 4.4; 95% CI, 2.3-8.5). Furthermore, the likelihood of wearing long sleeves and hats increased more than did the likelihood of applying sunscreen (OR 3.3; 95% CI, 1.8-6.0 and OR 3.6; 95% CI, 1.9-6.7 vs OR 1.7; 95% CI, 1.0-2.8, respectively).

Additional research is warranted to quantify the long-term effects of skin cancer-focused clinics on skin cancer-related morbidity and mortality in organ transplant recipients.

Reference

Hartman RI, Green AC, Gordon LG; Skin Tumours and Allograft Recipients (STAR) Study. Sun protection among organ transplant recipients after participation in a skin cancer research study [published online June 6, 2018]. JAMA Dermatol. doi: 10.1001/jamadermatol.2018.1164

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