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

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.

Sun exposure and protection habits in transplant athletes: An international survey

“…16 Few studies have analyzed history of sunburn in transplant recipients, and it is therefore difficult to draw comparisons. Haney et al, 17 however, reported a rate of just 2.9% for liver transplant recipients in Turkey in 2016, which is almost 10 times lower than the rate detected in our series.…”

“…Sunburn was more common in athletes with no studies or with primary education only than in those with a secondary or third‐level education (58.3% vs 26.6%, p = .045), contrasting with previous reports by Haney et al 17 in their study of liver transplant recipients.…”

“…22 In our study, we observed significant differences in the prevalence of sunburn in athletes aged <50 years vs ≥50 years (37.2% vs 21.6%, p = .041); the respective rates, however, were lower than those reported for cyclists aged ≤40 vs >40 years (60.3% vs 46.2%, p < .001). 15 Sunburn was more common in athletes with no studies or with primary education only than in those with a secondary or third-level education (58.3% vs 26.6%, p = .045), contrasting with previous reports by Haney et al 17 in their study of liver transplant recipients.…”

“…We did not, for instance, have any information on immunosuppressive treatment switches or dosages or on whether the skin cancer had developed before or after the transplant, whether it was a primary or recurrent tumor, and how it had been treated. Using a questionnaire, however, facilitated comparisons with other studies that have used a similar method to explore sun‐related behaviors and knowledge in other populations, such as immunocompetent adults, 16 athletes, 14,15 transplant recipients, 8,17,25 and beachgoers 26 . Given insufficient statistical power, a limitation of the study is the impossibility of performing stratified analyzes for age and skin type to adjust results regarding both the presence of sunburn and skin history.…”