Specialist dermatology clinics for organ transplant recipients significantly improve compliance with photoprotection and levels of skin cancer awareness
Specialist dermatology clinics for organ transplant recipients significantly improve compliance with photoprotection and levels of skin cancer awareness
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DOI：
10.1111/j.1365-2133.2006.07454.x
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发表时间：
2006-11-01
影响因子：
10.3
通讯作者：
Harwood, C. A.
中科院分区：
文献类型：
--
作者：
Ismail, F.;Mitchell, L.;Harwood, C. A.
背景器官移植受者发生鳞状细胞癌的风险增加100倍。累积暴露于紫外线辐射是主要的危险因素，有证据表明缺乏皮肤学监测可能是OTR对皮肤癌知识和光防护水平低下的原因。目的本研究评估了OTR皮肤科专科诊所的常规咨询是否能提高对皮肤癌风险的了解和对光防护措施的遵从性。方法在英国伦敦Bart‘s和伦敦NHS Trust的OTR皮肤科专科诊所进行了一项基于横断面问卷的研究。受试者是肾移植诊所接受监测的399名白皮肤患者，他们从肾移植诊所寄出了一份邮寄问卷。结果292人(73%)回答，其中89%以前曾到皮肤科专科诊所就诊。96%的人回忆起至少接受过一次光防护建议(85%来自皮肤科医生)；92%的人报告使用过防晒霜；88%的人专门穿衣服来保护自己；96%的人直接避免在夏天暴露在阳光下；68%的人意识到皮肤癌风险的增加是移植后额外的光保护措施很重要的原因。在那些从未去过专科诊所的应答者中，光防护措施和皮肤癌意识水平明显较低。在无反应者中没有发现明显的偏见。结论我们的患者群体对皮肤癌的认识和对光保护措施的遵从性通常比以前报道的要高，这表明如果在皮肤科专科环境中提供关于皮肤癌的教育信息的传递可能会得到改善。
Background Organ transplant recipients (OTRs) have 100-fold increased risk of developing squamous cell carcinomas. Cumulative exposure to ultraviolet radiation is the main risk factor and there is evidence that lack of dermatological surveillance may be responsible for poor levels of knowledge and photoprotection among OTRs.Objectives This study evaluated whether routine consultation in a specialist OTR dermatology clinic improves understanding of skin cancer risk and compliance with photoprotection measures.Methods A cross-sectional questionnaire-based study was performed in a specialist OTR dermatology clinic at Bart's and the London NHS Trust, London, U.K. The subjects were 399 white-skinned patients under surveillance in a renal transplant clinic, who were sent a postal questionnaire from the renal transplant clinic. The main outcome measures were responses to the questionnaire regarding photoprotective practices and skin cancer risk awareness.Results Two hundred and ninety-two of 399 (73%) responded, of whom 89% had previously attended the specialist dermatology clinic. Ninety-six per cent recalled receiving photoprotection advice at least once (85% from dermatologists); 92% reported use of sunscreen; 88% specifically dressed to photoprotect themselves; 96% directly avoided sun exposure during summer; 68% were aware that an increased risk of skin cancer was the reason that extra photoprotective measures were important after a transplant. Photoprotective measures and level of skin cancer awareness were significantly lower in those responders who had never attended the specialist clinic. No obvious bias was identified among nonresponders.Conclusions Skin cancer awareness and compliance with photoprotective measures in our patient population is generally greater than previously reported, suggesting that delivery of educational messages regarding skin cancer may be improved if provided in a specialist dermatological setting.