Factors influencing patient follow-up after skin cancer removal: A retrospective cohort study

Summary: Follow-up with a dermatologist for total body skin exams after skin cancer removal is important as this may help with earlier detection of new skin cancers and is recommended by the National Comprehensive Cancer Network (NCCN). Limited research studies have highlighted clinical and sociodemographic factors that influence patient adherence to follow-up. This study examines the patients’ sociodemographic and clinical factors that may affect follow-up adherence after skin cancer removal procedures at The Emory Dermatology Clinic. Among 200 patients randomized for the pilot, 159 were determined eligible. Patients who passed during the follow-up period, did not have documented skin cancer removal procedures, or received most dermatological care outside the Emory Dermatology Clinic were excluded. The cohort’s average age is 64.2 years. Most participants were white (96.9%) and had Medicare (64.2%). Follow-up adherence declined from 85.5% of patients attending at least one follow-up visit in the first year to only 38.4% attending consecutive follow-ups for five years. Univariate and multivariate logistic regression models were used to identify barriers and facilitators of follow-up adherence. Facilitators of follow-up adherence included being married, having higher levels of educational attainment, and having a personal history of multiple skin cancers. Insurance type, skin cancer removal procedure type, site of skin cancer, psychiatric comorbidities, and mobility issues did not significantly affect patient follow-up adherence. Our findings suggest that dermatologists may play an important role in improving follow-up adherence by (1) tailoring patient communication to the appropriate level of comprehension and (2) identifying patients who are more socially isolated and offering them outlets of support. Richard Chen¹, Travis Blalock¹ 1. Dermatology, Emory University School of Medicine, Atlanta, GA, United States. Clinical Research: Epidemiology and Observational Research