title: Specialist dermatology clinics for organ transplant recipients significantly improve compliance with photoprotection and levels of skin cancer awareness.
abstract: 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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Centre for Cutaneous Research, Institute of Cell and Molecular Science, St Bartholomew's and the Royal London School of Medicine and Dentistry, Queen Mary, University of London, London E1 2AT, UK. f.ismail@qmul.ac.uk
authors.forename: F
authors.initials: F
authors.lastname: Ismail
authors.forename: L
authors.initials: L
authors.lastname: Mitchell
authors.forename: D
authors.initials: D
authors.lastname: Casabonne
authors.forename: A
authors.initials: A
authors.lastname: Gulati
authors.forename: R
authors.initials: R
authors.lastname: Newton
authors.forename: C M
authors.initials: CM
authors.lastname: Proby
authors.forename: C A
authors.initials: CA
authors.lastname: Harwood
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008131:London; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000209:etiology / Q000517:prevention & control; D010044:Outpatient Clinics, Hospital; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000209:etiology / Q000517:prevention & control*; D012880:Skin Pigmentation; D013473:Sunscreening Agents / Q000008:administration & dosage; D011795:Surveys and Questionnaires; D014466:Ultraviolet Rays / Q000009:adverse effects
chemical_list: D013473:Sunscreening Agents