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J Invest Dermatol. 2019 Sep;139(9):1898-1905.e2. doi: 10.1016/j.jid.2019.02.033. Epub 2019 Apr 5.

Skin Cancer Early Detection Practices among Adult Survivors of Childhood Cancer Treated with Radiation.

Author information

1
Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA. Electronic address: ageller@hsph.harvard.edu.
2
Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA.
3
Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA.
4
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
5
Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
6
Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.
7
Department of Radiation Physics, The University of Texas at MD Anderson Cancer Center, Houston, Texas, USA.
8
Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.

Abstract

Because rates of skin cancer are greater among adult survivors of childhood cancer who received radiation therapy than among the general population, the National Cancer Institute recommends skin self-examinations and annual physician examination. There has been no comprehensive assessment of survivors' adherence to the skin cancer screening guidelines associated with skin self-examination (SSE) and physician whole-body skin examination (PSE). We conducted a cross-sectional survey of radiation-treated, adult 5-year survivors of childhood cancer, diagnosed between 1970 and 1986, in the Childhood Cancer Survivor Study cohort. Multivariate multinomial logit regression investigated the association between demographic, cancer diagnosis, patient activation, cancer treatment characteristics, and skin cancer screening practice. Among 728 survivors, 13.1% reported performing SSE in the prior 2 months plus receiving PSE in the prior 12 months, and 16.4% and 11.0% reported performing only an SSE or a PSE, respectively; 59.5% of survivors reported having had neither. Participants at the highest patient activation score were most likely to report SSE plus PSE compared with neither (adjusted relative risk ratio = 4.16, 95% confidence interval = 1.34-12.85). Most adult survivors of childhood cancer who had radiation therapy do not practice strategies that promote early detection of skin cancer. Interventions designed to activate survivors to increase their participation in screening are needed.

PMID:
30959042
PMCID:
PMC6708770
[Available on 2020-09-01]
DOI:
10.1016/j.jid.2019.02.033
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