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Education and Awareness of Skin Cancer Risk in Liver Transplant and IBD Patients: A Comparison

Authors

Campbell V, McDougall N, Turner GB

Departments / Institutions

Royal Victoria Hospital, Belfast, UK

Publication Date

Spring 2014

Introduction

The risk of non-melanoma skin cancer (NMSC) is increased with immunosuppression therapy. Our aim was to compare how aware liver transplant and IBD patients, attending two separate services, were of this increased risk. Liver transplant recipients received formal education regarding skincare at time of transplantation. The IBD group received this on commencement of therapy and on an opportunistic basis. Thirty-four liver transplant patients (15 male, 19 female) and thirty-four IBD patients (19 male, 15 female) completed a questionnaire which assessed awareness of NMSC risk. Mean ages were 52 and 36 respectively. Of the transplant patients, 23 were on Tacrolimus, 2 on Azathioprine, 2 on Ciclosporin, and 7 on combination therapy. In the IBD group, 29 took Azathioprine and 5 Mercaptopurine.

Twenty-three (68%) transplant patients recalled being informed of the increased NMSC risk but two (6%) couldn’t remember and nine (26%) denied being informed. Eighteen (53%) IBD patients recalled being informed of the NMSC risk. Three (9%) couldn’t remember and thirteen (38%) denied being informed. For patients on therapy <2 years, 92% of transplant and 70.5% of IBD patients recalled being informed of the NMSC risk. Recall diminished as treatment duration increased. Only ten (29%) transplant and eleven (32%) IBD patients were aware of what skin changes to look out for. Despite increasing awareness of NMSC risk in physicians, there remains a significant level of ignorance among patients. We suggest implementing a skincare proforma to document patient education on a more frequent basis, particularly targeting patients on therapy >10 years.


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