Scalable Education Program Nearly Triples Skin Cancer Screening Rates in HCT Survivors
核心洞察
A City of Hope (搜索) study of 720 hematopoietic cell transplant survivors found a mailed education program with text reminders nearly tripled skin cancer screening rates overall.
When primary care physicians also received educational materials, in-office skin checks were 40% higher compared to patients whose doctors did not receive the outreach.
HCT survivors face nearly double the risk of squamous cell carcinoma (搜索) and other skin cancers, which often first appear three to five years post-transplant.
A remotely delivered education program targeting both hematopoietic cell transplant (HCT) survivors and their primary care physicians nearly tripled the rate of skin cancer screening, according to new research from City of Hope (搜索) published in JNCCN—Journal of the National Comprehensive Cancer Network.
The "patient activation and education" program randomized 720 transplant survivors into two groups. All participants received mailed educational materials detailing their elevated skin cancer risk, instructions for performing self-exams, and reference images of suspicious lesions. Regular text messages reinforced the information. For approximately half the cohort, researchers also sent the patients' primary care doctors information on the link between HCT and skin cancer risk, along with guidance on performing full-body skin exams.
The results were striking. The percentage of patients completing self-exams and receiving annual skin checks from their doctors nearly tripled overall. Sending materials to physicians appeared to make the greatest impact: the portion of patients who received an in-office skin check was 40% higher among those whose primary care physicians received educational materials compared to those whose physicians did not.
"One notable finding was how effective patient education alone was in increasing self-examination, even without intensive intervention," said study first author Saro Armenian, D.O., M.P.H., the Barron Hilton Chair in Pediatrics and director of the Center for Survivorship and Outcomes at City of Hope (搜索)'s Hematologic Malignancies Research Institute. "At the same time, the added benefit of physician activation specifically for clinical exams reinforces how critical provider education remains."
Elevated Risk and the Screening Gap
HCT, also known as bone marrow transplant or stem cell transplant, is used to treat patients with leukemia (搜索), lymphoma (搜索), multiple myeloma (搜索), and other blood cancers, as well as conditions like aplastic anemia (搜索) and sickle cell disease (搜索). Survivors face nearly double the risk of cutaneous squamous cell carcinoma (搜索) and other skin cancers, including basal cell carcinoma (搜索), melanoma (搜索), and Merkel cell carcinoma (搜索). These malignancies often first appear three to five years after transplant, making regular skin self-exams and annual clinical skin checks essential.
Despite this elevated risk, screening rates remain low, particularly after survivors transition out of specialty care. "HCT survivors face a markedly elevated risk of skin cancer, yet screening rates remain low, especially after they transition out of specialty care. This study shows that practical, scalable solutions can close that gap and may be applicable to other long-term complications in cancer survivors," Dr. Armenian said.
A Coordinated, Scalable Approach
Patient activation programs exist in other areas of chronic disease and cancer survivorship, but they have rarely been applied in a coordinated way to both transplant survivors and the primary care physicians providing their care. The City of Hope (搜索) study represents a new approach that engages both groups using a model designed for broad expansion to reach many people at high cancer risk.
At City of Hope (搜索), survivorship is considered a core responsibility of cancer care and a non-negotiable part of every patient's treatment timeline. The institution's researchers contribute to understanding why late effects occur, who is most at risk, and how earlier intervention can protect long-term health.
Translation into Clinical Practice
Dr. Armenian said his team's findings are already being incorporated into how City of Hope (搜索) provides follow-up care. "These results are informing how we think about survivorship care delivery, particularly the use of remote, low-intensity strategies to support patients as they transition to primary care," he said. "The approach aligns well with efforts to scale risk-based, technology-enabled survivorship models across broader populations."