Low Rates of Dermatologic Care and Skin Cancer Screening Among Inflammatory Bowel Disease Patients
| Autor: | Benjamin H. Click, Laura K. Ferris, Alyce Anderson, Ioannis E. Koutroubakis, Jana G. Hashash, David G. Binion, Claudia Ramos-Rivers, Arthur Barrie, Miguel Regueiro, Marc Schwartz, Michael A. Dunn |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Skin Neoplasms Physiology Dermatology Health Services Misuse Risk Assessment Skin Diseases Inflammatory bowel disease 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Ambulatory Care medicine Humans Family history Early Detection of Cancer business.industry Incidence Incidence (epidemiology) Gastroenterology Middle Aged Hepatology Inflammatory Bowel Diseases medicine.disease United States Natural history 030220 oncology & carcinogenesis Cutaneous melanoma Female 030211 gastroenterology & hepatology Skin cancer business Contact dermatitis Needs Assessment |
| Zdroj: | Digestive Diseases and Sciences. 63:2729-2739 |
| ISSN: | 1573-2568 0163-2116 |
| DOI: | 10.1007/s10620-018-5056-x |
| Popis: | Dermatologic manifestations of inflammatory bowel disease (IBD) are common, and certain IBD medications increase the risk of skin cancer. To define the rates of care and factors associated with dermatologic utilization with a focus on skin cancer screening. We utilized a prospective, natural history IBD research registry to evaluate all outpatient healthcare encounters from 2010 to 2016. Gastrointestinal, dermatologic and primary care visits per individual were identified. We calculated the proportion of patients obtaining care, categorized primary indications for dermatologic visits, determined the incidence of melanoma and non-melanoma skin cancers, and used logistic regression to determine factors associated with dermatology utilization. Of the 2127 IBD patients included, 452 (21.3%) utilized dermatology over the study period, and 55 (2.6%) had a total body skin examination at least once. The 452 patients incurred 1633 dermatology clinic visits, 278 dermatologic procedures, and 1108 dermatology telephone encounters. The most frequent indication was contact dermatitis or dermatitis. Factors associated with dermatology use were family history of skin cancer, employment, systemic steroids, longer disease duration, emergency room use, and the number of IBD-related clinic visits. Between 8.3 and 11% of IBD patients recommended for skin cancer screening visited dermatology each year, and the resulting incidence of non-melanoma skin cancer was 35.4/10,000 [95% CI 23.3–51.5] and melanoma was 6.56/10,000 [95% CI 2.1–15.3]. Less than one in ten IBD patients obtain dermatologic care. Given the increased risk of skin cancers among IBD patients, an emphasis on education, prevention, and screening merits attention. |
| Databáze: | OpenAIRE |
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