title: Longitudinal, mixed method study to look at the experiences and knowledge of non melanoma skin cancer from diagnosis to one year.
abstract: BACKGROUND
  Skin cancer is the most common type of cancer in humans and the incidence is increasing worldwide. Our objective was to understanding the needs, experiences and knowledge of individuals with Non Melanoma Skin Cancer (NMSC) from diagnosis up until one year.
  
  
  METHODS
  Patients with NMSC completed questionnaires at diagnosis, treatment, 8 weeks post treatment and 12 months post diagnosis. Body image, psychological morbidity and Quality of Life (QOL) were assessed at each time point, with the exception of QOL that was not assessed at diagnosis. Knowledge of NMSC was assessed at baseline and 8 weeks. A sub-sample of participants was also interviewed to allow a more in-depth exploration of patients' experiences.
  
  
  RESULTS
  76 participants completed the initial questionnaire, of which 15 were interviewed. Patients were anxious about a diagnosis of skin cancer, however they were no more depressed or anxious than the general population. QOL significantly improved from diagnosis to 8 weeks and from diagnosis to one year. Knowledge of NMSC was poor and did not improve after treatment. Hairdressers were highlighted as playing an important role in raising awareness and encouraging individuals to seek medical help. Most participants were aware of the need to check their skin for suspicious lesions but were not sure what to look for. At one year participants had forgotten their experience and were not overly concerned about skin cancer.
  
  
  CONCLUSIONS
  There is a need to raise awareness of the signs and symptoms of NMSC. Information on skin cancer needs to be tailored to the individual both at the start of treatment and during the follow up months, ensuring that participants' needs and expectations are met. Targeting education at individuals in the community who regularly come into contact with skin should help in early identification of NMSC. This is important since skin cancer caught early is easily treatable and delay in presentation leads to larger and more complex lesions which impacts in terms of increased morbidity and increased health care costs.
authors.affiliation: School of Health Sciences, Faculty of Medicine & Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, UK. fiona.bath-hextall@nottingham.ac.uk.
authors.forename: Fiona
authors.initials: F
authors.lastname: Bath-Hextall
authors.forename: Claire
authors.initials: C
authors.lastname: Jenkinson
authors.forename: Arun
authors.initials: A
authors.lastname: Kumar
authors.forename: Jo
authors.initials: J
authors.lastname: Leonardi-Bee
authors.forename: William
authors.initials: W
authors.lastname: Perkins
authors.forename: Karen
authors.initials: K
authors.lastname: Cox
authors.forename: Cris
authors.initials: C
authors.lastname: Glazebrook
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology; D001828:Body Image; D002277:Carcinoma / Q000175:diagnosis / Q000523:psychology*; D003863:Depression / Q000209:etiology; D004739:England; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012878:Skin Neoplasms / Q000175:diagnosis / Q000523:psychology*; D011795:Surveys and Questionnaires