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Technology-enabled activation of skin cancer screening for hematopoietic cell transplantation survivors and their primary care providers (TEACH).
- Source :
-
BMC cancer [BMC Cancer] 2020 Aug 03; Vol. 20 (1), pp. 721. Date of Electronic Publication: 2020 Aug 03. - Publication Year :
- 2020
-
Abstract
- Background: Hematopoietic cell transplantation (HCT) is a curative option for a growing number of patients with hematologic diseases and malignancies. However, HCT-related factors, such as total body irradiation used for conditioning, graft-versus-host disease, and prolonged exposure to immunosuppressive therapy, result in very high risk for melanoma and non-melanoma skin cancer (NMSC). In fact, skin cancer is the most common subsequent neoplasm in HCT survivors, tending to develop at a time when survivors' follow-up care has largely transitioned to the primary care setting. The goal of this study is to increase skin cancer screening rates among HCT survivors through patient-directed activation alone or in combination with physician-directed activation. The proposed intervention will identify facilitators of and barriers to risk-based screening in this population and help reduce the burden of cancer-related morbidity after HCT.<br />Methods/design: 720 HCT survivors will be enrolled in this 12-month randomized controlled trial. This study uses a comparative effectiveness design comparing (1) patient activation and education (PAE, N = 360) including text messaging and print materials to encourage and motivate skin examinations; (2) PAE plus primary care physician activation (PAE + Phys, N = 360) adding print materials for the physician on the HCT survivors' increased risk of skin cancer and importance of conducting a full-body skin exam. Patients on the PAE + Phys arm will be further randomized 1:1 to the teledermoscopy (PAE + Phys+TD) adding physician receipt of a portable dermatoscope to upload images of suspect lesions for review by the study dermatologist and an online course with descriptions of dermoscopic images for skin cancers.<br />Discussion: When completed, this study will provide much-needed information regarding strategies to improve skin cancer detection in other high-risk (e.g. radiation-exposed) cancer survivor populations, and to facilitate screening and management of other late effects (e.g. cardiovascular, endocrine) in HCT survivors.<br />Trial Registration: ClinicalTrials.gov, NCT04358276 . Registered 24 April 2020.
- Subjects :
- Humans
Cancer Survivors
Costs and Cost Analysis
Patient Education as Topic
Physicians, Primary Care
Self-Examination methods
Randomized Controlled Trials as Topic
Dermoscopy
Telemedicine
Skin diagnostic imaging
Hematopoietic Stem Cell Transplantation adverse effects
Hematopoietic Stem Cell Transplantation methods
Hematopoietic Stem Cell Transplantation statistics & numerical data
Physical Examination methods
Skin Neoplasms diagnosis
Skin Neoplasms etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2407
- Volume :
- 20
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC cancer
- Publication Type :
- Academic Journal
- Accession number :
- 32746799
- Full Text :
- https://doi.org/10.1186/s12885-020-07232-2