Reducing Skin Cancer Risk in Childhood Cancer Survivors
Condition: Skin Neoplasms
MeSH terms: Skin Neoplasms
Study type: Interventional

Summary: 
      The objective of this study is to determine the impact of a 12-month patient activation and
      education intervention on skin cancer early detection practices among childhood cancer
      survivors treated with radiation. This randomized controlled trial uses a three-group design.

      Our specific aims are to: (1) Determine the impact of a Patient Activation and Education
      intervention with and without physician activation and teledermatology on skin cancer early
      detection practices, (2) Determine the impact of the intervention on time to diagnosis, and
      (3) Estimate the cost and cost-effectiveness of the intervention as a secondary outcome.
    

Detailed description: 
      There are currently more than 420,000 Americans who are long-term survivors of childhood and
      adolescent cancer. While these groups have greatly benefited from recent medical advances,
      primarily increasing overall survival rates, treatment advances have come at a cost. It is
      now clear that childhood radiation therapy has caused survivors to be at extremely high risk
      for non-melanoma skin cancer (NMSC) and increased risk of melanoma. Early detection is
      crucial to reduce the morbidity caused by NMSCs and the morbidity and mortality incurred due
      to melanoma. Both patient and provider action are needed to detect and treat early skin
      cancers and to find new solutions to ensure expedited follow-up care and treatment,
      especially among those who live where they have little access to dermatologists.

      The objective of this study is to determine the impact of a 12-month patient activation and
      education intervention on skin cancer early detection practices among childhood cancer
      survivors treated with radiation. All participants will receive text messages encouraging
      them to examine their skin and request physician examinations while concurrently driving them
      to a study website that provides education related to the associated skills, and reinforces
      and expands the text messages. To reduce skin cancers among this young and dispersed patient
      population, this study will address several key issues: (1) how to provide patients with the
      skills needed to conduct effective skin self-examinations; 2) how to prompt action from
      patient's physicians when worrisome moles and lesions are found; and 3) how to ensure rapid
      access to dermatologic exams, which in some parts of the US can take weeks or months to
      schedule.
    

Intervention name(s): Patient activation and education (PAE); PAE plus physician activation (PAE + MD); PAE physician activation, plus teledermoscopy (PAE +MD +TD)
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Text messaging and web-based tutorials for a 12-month duration (a website and smartphone interface); Text messaging and web-based tutorials for a 12-month duration (a website and smartphone interface), physician activation/educational materials about: (1) survivors' increased skin cancer risk; (2) the benefits of and the skills needed to conduct full-body skin exams; and (3) the importance of recommending routine SSE to patients; Text messaging and web-based tutorials for a 12-month duration (a website and smartphone interface), physician activation/educational materials about: (1) survivors' increased skin cancer risk; (2) the benefits of and the skills needed to conduct full-body skin exams; and (3) the importance of recommending routine SSE to patients, and participant receipt of a dermoscopic lens
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Screening
Keywords: Skin neoplasms; Radiation; Screening; Self-examination; Comparative effectiveness research; Dermoscopy