Current Perspectives Among U.S. Dermatologists on Chemoprevention of Nonmelanoma Skin Cancer: A Survey-Based Study

May 2017 | Volume 16 | Issue 5 | Original Article | 449 | Copyright © 2017

Brittany Oliver BS,a Serena Durrani BA,b Joel L. Cohen MD,c and Adam J. Friedman MDd

aGeorge Washington University School of Medicine and Health Sciences, Washington, DC bEmory Rollins School of Public Health, Atlanta, GA cAboutSkin Dermatology and DermSurgery, Greenwood Village, CO dDepartment of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC

Abstract

Introduction: Nonmelanoma skin cancer (NMSC) is the most common malignancy in the US Primary prevention of NMSC with physical photoprotective measures are often not sufficient to impact skin cancer incidence in high-risk individuals. Chemoprevention is the use of agents to prevent, suppress, and reverse carcinogenic progression. Many agents have been investigated, but preclinical and clinical studies are often inconsistent.

Methods: A cross-sectional study was designed to assess current practices, perceptions, and general knowledge of U.S. dermatologists pertaining to chemopreventive strategies. This voluntary online survey was distributed to practicing dermatologists via dermatology society electronic mailing lists. Software from SurveyGizmo.com was used for survey implementation and anonymous data collection. Stata 12.0 statistical analysis software (StataCorp, LP) was used to perform nonparametric Spearman correlation tests.

Results: Approximately half of the 156 responding dermatologists reported being in practice 16 years or more (47.3%) and working in urban communities (48.7%). 59.3% reported “frequently” using topical therapies, while only 13.7% reported frequent use of systemic chemopreventive therapies. Dermatologists practicing in urban settings were more likely to indicate they believe knowledge has increased substantially (P=0.047) as compared to colleagues in other communities. Respondents also reported varying degrees of confidence in selecting appropriate chemopreventive regimens: most feel comfortable determining which agents to use in patients, but 29.1% answered “neutral” or “disagree” when asked if they felt comfortable. More experienced dermatologists were more likely to recommend diet modifications such as increased dietary vitamin D (P=0.014), low fat diet (P=0.022), and tea polyphenols (P=0.04) as methods of chemoprevention.

Discussion: Efforts to identify effective, minimally-toxic chemopreventive agents have long been underway, but conflicting reports in the literature make formulation of validated guidelines challenging. Our study suggests differing perceptions, comfort levels, and practice strategies among U.S. dermatologists. This serves to identify areas of research requiring additional contributions from clinical investigators and reveals a need to broaden understanding of available evidence-based techniques.

J Drugs Dermatol. 2017;16(5):449-452.

Purchase Original Article

Purchase a single fully formatted PDF of the original manuscript as it was published in the JDD.

Download the original manuscript as it was published in the JDD.

Contact a member of the JDD Sales Team to request a quote or purchase bulk reprints, e-prints or international translation requests.

To get access to JDD's full-text articles and archives, upgrade here.

Save an unformatted copy of this article for on-screen viewing.

Print the full-text of article as it appears on the JDD site.

→ proceed | ↑ close

INTRODUCTION

Nonmelanoma skin cancer (NMSC) is the most common malignancy in the US1 Primary prevention of NMSC with physical photoprotective measures are often not sufficient to impact skin cancer incidence in high-risk individuals. Chemoprevention is the use of agents to prevent, suppress, and reverse carcinogenic progression.2 Many potential therapies have been investigated, but results of preclinical and clinical studies are inconsistent. A cross-sectional study utilizing a validated survey was designed to assess current practices, perceptions, and general knowledge of U.S. dermatologists pertaining to chemopreventive strategies, with particular interest in investigating what factors may influence responses given. With approval from the George Washington University Institutional Review Board, this anonymous, voluntary survey was distributed to the Association of Professors of Dermatology and Orlando Dermatology Aesthetic & Clinical Conference electronic mailing lists. Software from SurveyGizmo (www.surveygizmo.com) was used for survey implementation and data collection. Analysis by demographic factors were planned a priori. Stata 12.0 statistical analysis software (StataCorp, LP) was used to perform nonparametric Spearman correlation tests.A response rate of 21.9% was achieved with a survey completion rate of 87.2%. Of the responding dermatologists (n=156), approximately half reported being in practice 16 years or more (47.3%) and working in urban communities (48.7%). History 

↑ back to top


Related Articles