Effectiveness of Behavioral Interventions for Promoting Sun-Protection and Preventing Skin Cancer in Solid Organ Transplant Recipients: A Systematic Review.

Abstract

Background and Aim: The incidence of skin cancer is increased in solid organ transplant recipients. We aimed to assess the effectiveness of behavioral interventions for sun-protection and prevention of skin cancer in transplant recipients. Methods: We systematically searched MEDLINE, Embase, CINAHL, and the Cochrane Trials Register to December 2012 to identify randomized and nonrandomized trials that evaluated behavioral interventions to promote sun protection in solid organ transplant recipients. Results: Five studies (n=747 participants) were included. Study outcomes included change in knowledge, sun-protective behaviors, incidence of actinic keratosis and non-melanoma skin cancer (Table 1). Provision of sunscreen reduced the incidence of actinic keratosis, basal cell carcinoma and squamous cell carcinoma. Knowledge of sun protective behaviors was not improved as a result of passive interventions (e.g. pamphlets). Some specific sun-protective behaviors (e.g. sun screen use) were improved compared to standard care. Conclusion: Ready supply of sunscreen appears effective in reducing the incidence of skin cancer related outcomes in solid organ transplant recipients. Active interventions (e.g. counseling, dermatology clinics) rather than passive interventions are promising strategies for improving sun-protective behavior.Table: No Caption available.