Knowledge Gaps on Skin Cancer and Sun Protection in Organ Transplant Recipients Under Long-term Immunosuppression

Organ transplant recipients (OTRs) face an elevated risk of skin cancer due to ultraviolet radiation (UVR) exposure and the need for chronic immunosuppression. Patient education is essential for early skin cancer detection and prevention. This cross-sectional study evaluated knowledge and attitudes regarding sun protection and skin cancer among 177 OTRs during their routine check-up at a specialized dermatologic outpatient clinic in a German University Hospital, using the validated Skin Cancer and Sun Knowledge (SCSK) scale. Demographic, clinical and transplant-related variables were analysed to identify factors associated with specific knowledge gaps. The mean SCSK score was 16.59 (standard deviation, SD±3.96). While most patients understood basic sun protection, key deficits were noted in their understanding of tanning risks, the meaning of sun protection factor (SPF) and symptoms of skin cancer. Heart transplant recipients (p=0.002) and those with immunosuppression >3 years (p=0.028) had significantly lower scores indicating inferior knowledge. Male sex and age 60 years were also associated with lower knowledge levels. Self-reported "well-informed" patients scored significantly higher (p=0.003). Despite specialized routine dermatologic care, knowledge gaps persist in high-risk subgroups of OTRs, highlighting the need for targeted, longitudinal education strategies in interdisciplinary transplant aftercare.