Advancing Survivors' Knowledge (ASK) about skin cancer study: study protocol for a randomized controlled trial

• Type of Material: Article
• Authors: Casey L. Daniel, Harvard University; Gregory T. Armstrong, St. Jude Children's Research Hospital; Robyn R. Keske, Harvard University; Jessica A. Davine, Harvard University; Aaron J. McDonald, St. Jude Children's Research Hospital; Kim M. Sprunck-Harrild, Dana-Farber Cancer Institute; Catherine Coleman, Dana-Farber Cancer Institute; Sebastien J. Haneuse, Harvard University; Ann Mertens, Emory University; Karen M. Emmons, Kaiser Permanente; Ashfaq A. Marghoob, Memorial Sloan-Kettering Cancer Center; Elena B. Elkin, Memorial Sloan-Kettering Cancer Center; Stephen W. Dusza, Memorial Sloan-Kettering Cancer Center; Leslie L. Robison, St. Jude Children's Research Hospital; Alan C. Geller, Harvard University
• Language: English
• Date: 2015-03-24
• Publisher: BioMed Central
• Publication Version: Final Published Version
• Copyright Statement: © Daniel et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s13063-015-0637-x
• Title of Journal or Parent Work: Trials
• ISSN: 1745-6215
• Volume: 16
• Issue: 1
• Start Page: 109
• End Page: 109
• Grant/Funding Information: This work was supported by the National Cancer Institute (CA55727, GT Armstrong, Principal Investigator).; This study is funded by NCI grant R01 CA175231 (A Geller, Principal Investigator, Reducing Skin Cancer Risk among Childhood Cancer Survivors, 2013 to 2018).; Support to St. Jude Children’s Research Hospital also provided by the Cancer Center Support (CORE) grant (CA21765, R Gilbertson, Principal Investigator) and the American Lebanese-Syrian Associated Charities (ALSAC).; The first author is supported by NCI grant R25 CA057711 (G Sorensen, Principal Investigator).; Dana-Farber/Harvard Cancer Center is supported in part by an NCI Cancer Center Support Grant # NIH 5 P30 CA06516.
• Keywords: CHRONIC DISEASE; ADULT SURVIVORS; BASAL-CELL CARCINOMA; Life Sciences & Biomedicine; Medicine, Research & Experimental; PATIENT ACTIVATION MEASURE; Dermoscopy; Survivor; Skin cancer; HEALTH OUTCOMES; Childhood cancer; SELF-EXAMINATION; Health communication; Early detection; RADIATION-EXPOSURE; ADOLESCENT CANCER; Science & Technology; Research & Experimental Medicine; CHILDHOOD-CANCER; Melanoma; TRANSPLANT RECIPIENTS; Skin self-examination
• Research Categories: Psychology, Behavioral; Health Sciences, Oncology

Abstract

BACKGROUND: Advances in treatment have increased childhood cancer 5-year survival rates to greater than 80%. However, children previously treated with radiation are at significantly increased risk of developing subsequent neoplasms, the most common of which are skin cancers. The National Cancer Institute and Children's Oncology Group have issued recommendations for survivors treated with radiation to perform monthly skin self-examinations and receive a physician skin examination at least annually, as early detection has demonstrated markedly improved outcomes in the diagnosis and treatment of skin cancers. The goal of the present study is to increase rates of skin self-examinations and clinical skin examinations among adult survivors of childhood cancer treated with radiation. METHODS/DESIGN: This randomized controlled trial uses a 3-group comparative effectiveness design comparing: (1) Patient Activation and Education (PAE) including text messaging, print and web-based tutorials over 12 months; (2) PAE plus physician activation (PAE + MD) adding physician activation/educational materials about survivors' increased skin cancer risk and conducting full-body skin exams; and (3) PAE plus physician activation, plus teledermoscopy (PAE + MD + TD) adding participant receipt of a dermatoscope intended to empower them to photograph suspect moles or lesions for review by the study dermatologist. DISCUSSION: The current study addresses barriers to screening in this population by providing educational and motivational information for both survivors and physicians regarding the value of periodic skin examinations. It also utilizes innovative mobile health technology to encourage and motivate (that is activate) survivors to conduct skin self-examinations, request physician exams, and obtain treatment when worrisome lesions are found. Finally, as a comparative effectiveness trial, this study isolates the effects of adding specific components to the patient activation intervention to test the most effective intervention for enhancing skin examination vigilance among this high-risk group. TRIAL REGISTRATION: Clinicaltrials.gov: NCT02046811 ; Registration date: 22 January 2014.