Skin cancer evaluation in transplant patients: a physician opinion survey with recommendations

BackgroundNon-melanoma skin cancer is the most common malignancy in transplant patients. However, routine skin cancer evaluation is currently not the standard of care. ObjectiveTo investigate the current barriers among transplant physicians to skin cancer screening in their patients. To provide recommendations for appropriate routine skin surveillance. MethodsA web-based survey was conducted among Baylor, Dallas transplant physicians. Thirty-seven of 46 responses were received, and 13 physicians (28%) were classified as high screeners. ResultsThe univariate analysis revealed three main barriers including the perception of difficulty in seeing a dermatologist (p=0.017), skin cancer evaluation is not an important aspect of transplant care (p=0.038), and thirdly, the belief that there is insufficient evidence to warrant universal skin cancer screening in transplant patients (p=0.013). The fully adjusted multivariable analysis resulted in two significant conclusions; the most important predictor was the perceived lack of medical evidence for skin cancer screening. LimitationsThe small sample size and all responses being from the same institution in Texas. ConclusionThe dermatologic evidence for regular skin cancer screening in transplant patients needs dissemination to our transplant colleagues. This is a significant practice gap which can be appropriately closed by integrating dermatologists into the transplant team.