Education and Perspectives on the Use of Oral Skin Cancer Chemoprophylaxis: A Cross-Sectional Survey of Current Fellows in Mohs Micrographic Surgery & Dermatologic Oncology

Dermatol Surg. 2023 Dec 1;49(12):1072-1076. doi: 10.1097/DSS.0000000000003962. Epub 2023 Nov 2.

Abstract

Background: According to the curriculum guidelines of the Accreditation Council of Graduate Medical Education and the American Board of Dermatology, Mohs micrographic surgery & dermatologic oncology (MSDO) fellows must demonstrate competency in the use of oral skin cancer chemoprophylaxis. The current level of education in this area is unknown.

Objective: To characterize oral skin cancer chemoprophylaxis education for acitretin and nicotinamide among current MSDO fellows and to compare the clinical indications felt most appropriate for prescribing to a previously published expert consensus.

Methods: An electronic survey was distributed to all active MSDO fellows by the American College of Mohs Surgery.

Results: Responses were received from 63 (69.2%) MSDO fellows. Twenty (31.7%) and 37 (58.7%) fellows reported receiving fellowship training on acitretin and nicotinamide, respectively. Fifty-seven (90.5%) intend to prescribe chemoprophylaxis after training. Sixteen (28.1%) and 43 (75.4%) report feeling very comfortable prescribing acitretin and nicotinamide, respectively. Fellow concordance with a previously published expert consensus opinion on appropriate prescribing indications is variable. Forty-one (65.1%) indicated that additional education would increase the likelihood to prescribe after training.

Conclusion: Although most MSDO fellows intend to prescribe oral skin cancer chemoprophylaxis, a standardized curriculum may promote increased use and concordance with expert consensus recommendations.

MeSH terms

  • Acitretin / therapeutic use
  • Cross-Sectional Studies
  • Curriculum
  • Education, Medical, Graduate
  • Educational Status
  • Fellowships and Scholarships
  • Humans
  • Mohs Surgery / education
  • Mouth Neoplasms*
  • Niacinamide
  • Skin Neoplasms* / prevention & control
  • Skin Neoplasms* / surgery
  • Surveys and Questionnaires
  • United States

Substances

  • Acitretin
  • Niacinamide