Inadequate sunscreen use
Of the reasons respondents gave for not seeing a dermatologist, 64% said they “did not know about the increased risk” and 7% said that they “do not want to attend another doctor’s appointment.” Only 28% of respondents reported wearing sunscreen regularly, a slight increase from 22% who reported wearing sunscreen regularly before transplantation.
Reasons for not wearing sunscreen varied widely among survey participants, with 33% responding, “I forget to put it on,” and 25% reporting “I don’t think it is important to use sunscreen.” A total of 16% said they are “not in the sun very much,” 11% said “I like looking tan,” 8% said they “don’t like the way it feels,” and 5% said it “takes too much time” to put on.
“Our findings confirmed that the majority of transplant patients surveyed did not know they were at risk of developing skin cancer, and many of the reasons they gave for not practicing proper sun protection or seeing a dermatologist could be remedied by developing an intensive educational approach that raises awareness of the prevalence of this real health threat,” Dr. Youker said.
“Because the time around organ transplantation is consumed with the more pressing issues of rejection and infection, patients cannot be expected to recall information regarding the risk of sun exposure. Clearly, another method of informing patients of their risk is needed.”
Dr. Youker cited a related study published in Archives of Dermatology (2006;142:712-718). The study, titled “Educational Outcomes Regarding Skin Cancer in Organ Transplant Recipients,” found that patients who received an intensive educational program in which written reminders reinforced the risk of skin cancer fared significantly better in terms of complying with the recommended sun protection tips than those who did not receive this education.
The best approach, she said, may be to send transplant recipients regular correspondence in the mail or via email concerning the risk of skin cancer, and referring them to a dermatologist for initial skin screening, regular follow-up, and ongoing education. A dermatologist can assess the patient’s individual risk factors and offer detailed education about skin cancer prevention.