title: Pain identifies squamous cell carcinoma in organ transplant recipients: the SCOPE-ITSCC PAIN study.
abstract: Organ transplant recipients (OTR) are at high risk for cutaneous squamous cell carcinomas (SCC). We aimed to define clinically meaningful patient-reported warning signals predicting the presence of invasive SCC.Patient-reported signs and symptoms of 812 consecutively biopsied skin lesions from 410 OTR were determined by questionnaire and physical examination and related to the subsequent biopsy-proven diagnoses. Receiver-operating characteristic (ROC) curve analyses were used as a measure of distinction between the predictive values of patient-reported warning signals and the occurrence of SCC. Pain was an independent predictive patient-reported warning signal for a biopsy-proven invasive SCC. The odds ratio from the fully adjusted model predicting SCC was 4.4(95% confidence interval: 2.4–8.2). Higher scores on the visual analog scale (VAS) for pain were associated witha greater likelihood for the presence of SCC compared to none or mild pain. The for scores on the VAS from 1to 3, 4 to 6 and 7 to 10 were 4.9 (2.2–10.5), 2.3 (0.96–5.5)and 16.5 (3.6–75.8), respectively. Pain is the most powerful patient-reported warning signal for invasive cutaneous SCC in OTR. Empowerment of patients by education could accelerate diagnosis and treatment of cutaneous SCC.
authors.forename: J N
authors.initials: JN
authors.lastname: Bouwes Bavinck
authors.forename: C A
authors.initials: CA
authors.lastname: Harwood
authors.forename: R E
authors.initials: RE
authors.lastname: Genders
authors.forename: H C
authors.initials: HC
authors.lastname: Wisgerhof
authors.forename: E I
authors.initials: EI
authors.lastname: Plasmeijer
authors.forename: L
authors.initials: L
authors.lastname: Mitchell
authors.forename: E B
authors.initials: EB
authors.lastname: Olasz
authors.forename: D D
authors.initials: DD
authors.lastname: Mosel
authors.forename: M S
authors.initials: MS
authors.lastname: Pokorney
authors.forename: A L
authors.initials: AL
authors.lastname: Serra
authors.forename: L
authors.initials: L
authors.lastname: Feldmeyer
authors.forename: K
authors.initials: K
authors.lastname: Baumann Conzett
authors.forename: S
authors.initials: S
authors.lastname: Piaserico
authors.forename: A
authors.initials: A
authors.lastname: Belloni Fortina
authors.forename: K
authors.initials: K
authors.lastname: Jahn
authors.forename: A
authors.initials: A
authors.lastname: Geusau
authors.forename: M J P
authors.initials: MJ
authors.lastname: Gerritsen
authors.forename: D
authors.initials: D
authors.lastname: Seckin
authors.forename: A T
authors.initials: AT
authors.lastname: Gulec
authors.forename: P
authors.initials: P
authors.lastname: Cetkovska
authors.forename: J
authors.initials: J
authors.lastname: Ricar
authors.forename: B
authors.initials: B
authors.lastname: Imko-Walczuk
authors.forename: C M
authors.initials: CM
authors.lastname: Proby
authors.forename: G F L
authors.initials: GF
authors.lastname: Hofbauer
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D010146:Pain / Q000175:diagnosis*; D011379:Prognosis; D012307:Risk Factors; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000209:etiology; D011795:Surveys and Questionnaires