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Journal of Cancer Education

, Volume 34, Issue 1, pp 137–144 | Cite as

Skin Cancer-Sun Knowledge and Sun Protection Behaviors of Liver Transplant Recipients in Turkey

  • Meryem Ozturk Haney
  • Yaprak Sarigol Ordin
  • Gulcihan ArkanEmail author
Article
  • 99 Downloads

Abstract

The aim of this study was to compare liver transplant recipients (LTRs) with the general population regarding their knowledge of skin cancer, sun health, sun protection behaviors, and affecting factors. This cross-sectional study was conducted in Turkey between March 2016 and September 2016 with 104 LTRs and 100 participants from the general population group (GPG). The mean age of the LTRs was 53.2 ± 11.8 and that of the GPG was 42.7 ± 14.5. The LTRs’ skin cancer and sun knowledge were significantly lower than in the GPG, but there was no difference between the two groups in terms of their sun protection behavior scores. The most commonly used sun protection behaviors of LTRs were not being outside and not sunbathing between 10 a.m. and 4 p.m., wearing clothing that covers the skin, and avoiding the solarium. Behaviors commonly practiced by the GPG were wearing sunglasses, wearing sunscreen with a sun protection factor of 15 or higher before going outside, wearing sunscreen at the beach, while swimming or doing physical activity outside, and reapplying it every 2 h. Results of our study will contribute to the development of education and training programs for LTRs on skin cancer. The results also demonstrated the importance of practicing adequate sun protection behaviors which will certainly impact their future health.

Keywords

Liver transplantation Cancer Skin Knowledge Sun protection behavior 

Notes

Compliance with Ethical Standards

To conduct the study, written permission was obtained from the Ethics Committee of the Dokuz Eylul University, the hospitals and primary health care center where the study was to be conducted, and the municipality. After the purpose and the design of the study were explained to the participants, their written consent was obtained and the study was carried out with those who volunteered.

Ethics Statement

This study was reviewed and approved by the Dokuz Eylül University Ethical Committee.

Supplementary material

13187_2017_1279_MOESM1_ESM.doc (50 kb)
ESM 1 (DOC 49 kb)

References

  1. 1.
    Centers for Disease Control and Prevention (2013). United States Cancer Statistics, 2013. Available from: http://apps.nccd.cdc.gov/uscs/top ten cancers.aspx. Accessed April 21, 2016Google Scholar
  2. 2.
    Hanlon A, Colegio OR (2014) The cutting edge of skin cancer in transplant recipients: scientific retreat of international transplant skin cancer collaborative and skin cancer in organ transplant patients Europe. Am J Transplant 14(5):1012–1015CrossRefGoogle Scholar
  3. 3.
    Tufaro AP, Azoury SC, Crompton JG et al (2015) Rising incidence and aggressive nature of cutaneous malignancies after transplantation: an update on epidemiology, risk factors, management and surveillance. Surg Oncol 24(4):345–352CrossRefGoogle Scholar
  4. 4.
    Hofbauer GF, Bouwes Bavinck JN, Euvrard S (2010) Organ transplantation and skin cancer: basic problems and new perspectives. Exp Dermatol 19(6):473–482CrossRefGoogle Scholar
  5. 5.
    Keles Y, Tekin S, Duzenli M et al (2015) Post-transplantation malignancy after kidney transplantation in Turkey. Transplant Proc 47(5):1418–1420CrossRefGoogle Scholar
  6. 6.
    Geissler EK (2015) Skin cancer in solid organ transplant recipients: are mTOR inhibitors a game changer? Transplant Res 4:1CrossRefGoogle Scholar
  7. 7.
    Modaresi Esfeh J, Hanouneh IA, Dalal D et al (2012) The incidence and risk factors of de novo skin cancer in the liver transplant recipients. Int J Org Transplant Med 3(4):157–163Google Scholar
  8. 8.
    Mithoefer AB, Supran S, Freeman RB (2002) Risk factors associated with the development of skin cancer after liver transplantation. Liver Transpl 8(10):939–944CrossRefGoogle Scholar
  9. 9.
    Saraiye M, Glanz K, Briss PA et al (2004) Interventions to prevent skin cancer by reducing exposure to ultraviolet radiation: a systematic review. Am J Prev Med 27:422–466Google Scholar
  10. 10.
    SZ W, Jiang P, DeCaro JE, Bordeaux JS (2016) A qualitative systematic review of the efficacy of sun protection education in organ transplant recipients. J Am Acad Dermatol 75(6):1238–1244CrossRefGoogle Scholar
  11. 11.
    Bangash HK, Colegio OR (2012) Management of non-melanoma skin cancer in immunocompromised solid organ transplant recipients. Curr Treat Options in Oncol 13:354–376CrossRefGoogle Scholar
  12. 12.
    Firooz A, Amin-Nejad R, Bouzari N, Nafar M, Firoozan A, Mahdavi-Mazdeh M (2007) Sun protection in Iranian kidney transplant recipients: knowledge, attitude and practice. J Eur Acad Dermatol Venereol 21:754–757CrossRefGoogle Scholar
  13. 13.
    Ismail F, Mitchell L, Casabonne D et al (2006) Specialist dermatology clinics for organ transplant recipients significantly improve compliance with photoprotection and levels of skin cancer awareness. Br J Dermatol 155(5):916–925CrossRefGoogle Scholar
  14. 14.
    Chockalingam R, Christopher D, Tyring SK (2015) Cutaneous squamous cell carcinomas in organ transplant recipients. J Clin Med 4(6):1229–1239CrossRefGoogle Scholar
  15. 15.
    Terhost D, Drecoll U, Stockleth E, Ulrich C (2009) Organ transplant recipients and skin cancer: assessment of risk factors with focus on sun exposure. Br J Dermatol 161(Suppl. 3):85–89CrossRefGoogle Scholar
  16. 16.
    Feuerstein I, Alan CG (2008) Skin cancer education in transplant recipients. Prog Transplant 18(4):232–241CrossRefGoogle Scholar
  17. 17.
    Mihalis E, Wysong A, Boscardin WJ, Tang JY, Chren MM, Arron ST (2013) Factors affecting sunscreen use and sun avoidance in a U.S. national sample of organ transplant recipients. Br J Dermatol 168(2):346–353CrossRefGoogle Scholar
  18. 18.
    Ulrich C, Jurgensen JS, Degen A et al (2009) Prevention of non-melanoma skin cancer in organ transplant patients by regular use of a sunscreen: a 24 months, prospective, case-control study. Br J Dermatol 161(Suppl. 3):78–84CrossRefGoogle Scholar
  19. 19.
    Robinson JK, Rigel DS (2004) Sun protection attitudes and behaviours of solid-organ transplant recipients. Dermatol Surg 30:610–615PubMedGoogle Scholar
  20. 20.
    Thomas BR, Barnabas A, Agarwal K et al (2013) Patient perception of skin-cancer prevention and risk after liver transplantation. Clin Exp Dermatol 38:851–856CrossRefGoogle Scholar
  21. 21.
    Donovan JC, Rosen CF, Shaw JC (2004) Evaluation of sun-protective practice of organ transplant recipients. Am J Transplant 4:1852–1858CrossRefGoogle Scholar
  22. 22.
    Donovan JC, Shaw JC (2006) Compliance with sun protection following organ transplantation. Arch Dermatol 142:1232–1233CrossRefGoogle Scholar
  23. 23.
    Szepietowski JC, Reich A, Nowicka D, Weglowska J, Szepietowski T (2005) Sun protection in renal transplant recipients: urgent need for education. Dermatology 211(2):93–97CrossRefGoogle Scholar
  24. 24.
    Iannacone MR, Pandeya N, Isbel N (2015) Sun protection behavior in organ transplant recipients in Queensland, Australia. Dermatology 231:360–366CrossRefGoogle Scholar
  25. 25.
    Day AK, Wilson C, Roberts RM, Hutchinson AD (2014) The skin cancer and sun knowledge (SCSK) scale: validity, reliability, and relationship to sun-related behaviors among young western adults. Health Educ Behav 41(4):440–448CrossRefGoogle Scholar
  26. 26.
    Ozturk Haney M, Bahar Z, Beşer A, Arkan G, Cengiz B (2016) Psychometric testing of the Turkish version of the skin cancer and sun knowledge scale in nursing students. J Canc Educ.  https://doi.org/10.1007/s13187-016-1041-2
  27. 27.
    Robinson JK, Rigel DS, Amonette RA (1997) Trends in sun exposure knowledge, attitudes, and behaviors: 1986 to 1996. J Am Acad Dermatol 37:179–186CrossRefGoogle Scholar
  28. 28.
    Herman S, Rogers HD, Ratner D (2007) Immunosuppression and squamous cell carcinoma: a focus on solid organ transplant recipients. Skinmed 6(5):234–238CrossRefGoogle Scholar
  29. 29.
    Penn I (1987) Neoplastic consequences of transplantation and chemotherapy. Cancer Detect Prev suppl 1:149–157Google Scholar
  30. 30.
    Seukeran DC, Newstead CG, Cunliffe WJ (1998) The compliance of renal transplant recipients with advice about sun protection measures. Br J Dermatol 138:301–303CrossRefGoogle Scholar
  31. 31.
    Naylor MF, Boyd A, Smith DW et al (1995) High sun protection factor sunscreens in the suppression of actinic neoplasia. Arch Dermatol 31:170–175CrossRefGoogle Scholar
  32. 32.
    Berg D, Otley CC (2002) Skin cancer in organ transplant recipients: epidemiology, pathogenesis, and management. J Am Acad Dermatol 47:1–17CrossRefGoogle Scholar
  33. 33.
    Santmyire BR, Feldman SR, Fleischer AB (2001) Lifestyle high-risk behaviors and demographics may predict the level of participation in sun-protection behaviors and skin cancer primary prevention in the united states. Cancer 92(5):1315–1324CrossRefGoogle Scholar
  34. 34.
    Hay J, Coups EJ, Ford J, DiBonaventura M (2009) Exposure to mass media health information, skin cancer beliefs, and sun protection behaviors in a United States probability sample. J Am Acad Dermatol 61(5):783–792CrossRefGoogle Scholar
  35. 35.
    Falk M, Anderson CD (2013) Influence of age, gender, education al level and self-estimation of skin type on sun exposure habits and readiness to increase sun protection. Cancer Epidemiol 37:127–132CrossRefGoogle Scholar
  36. 36.
    Branström R, Kasparian NA, Chang Y et al (2010) Predictors of sun protection behaviors and severe sunburn in an international online study. Cancer Epidemiol Biomark Prev 19(9):2199–2210CrossRefGoogle Scholar
  37. 37.
    Mermelstein RJ, Riesenberg LA (1992) Changing knowledge and attitudes about skin cancer risk factors in adolescents. Health Psychol 11(6):371–376CrossRefGoogle Scholar

Copyright information

© American Association for Cancer Education 2017

Authors and Affiliations

  • Meryem Ozturk Haney
    • 1
  • Yaprak Sarigol Ordin
    • 2
  • Gulcihan Arkan
    • 3
    Email author
  1. 1.Public Health Nursing DepartmentDokuz Eylul University Faculty of NursingIzmirTurkey
  2. 2.Surgical Nursing DepartmentDokuz Eylul University Faculty of NursingIzmirTurkey
  3. 3.Public Health Nursing DepartmentDokuz Eylul University Faculty of NursingIzmirTurkey

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