LOS ANGELES — Experts at City of Hope ® , one of the nation’s largest and most advanced cancer research and treatment organizations, are shining a spotlight on the risk of skin cancer faced by hematopoietic cell transplant (HCT) survivors, as well as the need for early detection. New City of Hope research published in JNCCN—Journal of the National Comprehensive Cancer Network shows how a cost-effective, scalable education program targeting survivors and their doctors can significantly improve screening.
“HCT survivors face a markedly elevated risk of skin cancer, yet screening rates remain low, especially after they transition out of specialty care. This study shows that practical, scalable solutions can close that gap and may be applicable to other long-term complications in cancer survivors,” said study first author Saro Armenian , D.O., M.P.H., the Barron Hilton Chair in Pediatrics and director of the Center for Survivorship and Outcomes, Hematologic Malignancies Research Institute at City of Hope.
Hematopoietic cell transplant, also called bone marrow transplant or stem cell transplant, can be used to treat patients with leukemia, lymphoma, multiple myeloma and other blood cancers, as well as other conditions like aplastic anemia and sickle cell disease. Survivors face nearly double the risk of squamous cell carcinoma and other skin cancers, including basal cell carcinoma, melanoma and Merkel cell carcinoma. Skin cancers often first appear three to five years after the transplant, which is why performing regular skin self-exams and getting annual skin checks is so important.
City of Hope’s “patient activation and education” program split 720 transplant survivors randomly into two groups. Participants received educational materials through the mail, including information on their elevated skin cancer risk, instructions for performing a self-exam, and pictures of suspicious lesions for reference. All survivors also received regular text messages to reinforce the information.
For approximately half of the group, City of Hope also sent the patients’ primary care doctors information on the link between HCT and skin cancer risk and guidance on performing full-body skin exams.
The results were striking. The percentage of patients completing self-exams and receiving annual skin checks from their doctors nearly tripled overall.
Sending materials to physicians appeared to make the greatest impact. Although all patients participating in the study completed more self-exams, the portion of patients who also received an in-office skin check from their doctor was 40 percent higher among patients whose primary care physicians received educational materials compared to those whose physicians didn’t receive them.
“One notable finding was how effective patient education alone was in increasing self-examination, even without intensive intervention,” Dr. Armenian said. “At the same time, the added benefit of physician activation specifically for clinical exams reinforces how critical provider education remains.”
Patient activation programs exist in other areas of chronic disease and cancer survivorship, but they have rarely been applied in a coordinated way to both transplant survivors and the primary care physicians providing their care, he noted. The City of Hope study is a new approach that engages both transplant survivors and their doctors using a model that can easily be expanded to reach many people at high risk of cancer. At City of Hope, survivorship is considered a core responsibility of cancer care and is a non-negotiable part of every patient’s treatment timeline, ensuring patients continue to thrive after treatment ends. A national leader in survivorship research, City of Hope researchers are contributing to our understanding of why late effects occur, who is most at risk and how earlier intervention can protect long-term health.
Dr. Armenian said his team’s new findings are being incorporated into how City of Hope provides follow-up care for patients.
“These results are informing how we think about survivorship care delivery, particularly the use of remote, low-intensity strategies to support patients as they transition to primary care,” he said. “The approach aligns well with efforts to scale risk-based, technology-enabled survivorship models across broader populations.”
The paper, “Technology-Enabled Patient and Physician Activation to Enhance Skin Cancer Screening After HCT (TEACH Study): A Randomized Controlled Trial,” was published August 6, 2026, in JNCCN .
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The study was supported by the National Cancer Institute (R01 CA249460).
About City of Hope
City of Hope's mission is to make hope a reality for all touched by cancer and diabetes. Founded in 1913, City of Hope has grown into one of the largest and most advanced cancer research and treatment organizations in the United States, and one of the leading research centers for diabetes and other life-threatening illnesses. City of Hope research has been the basis for numerous breakthrough cancer medicines , as well as human synthetic insulin and monoclonal antibodies. With an independent, National Cancer Institute-designated comprehensive cancer center that is ranked among the nation’s top cancer centers by U.S. News & World Report at its core, City of Hope’s uniquely integrated model spans cancer care, research and development, academics and training, and a broad philanthropy program that powers its work. City of Hope’s growing national system includes its Los Angeles campus, Orange County, California, campus, a network of clinical care locations across Southern California and cancer treatment centers and outpatient facilities in the Atlanta, Chicago and Phoenix areas. City of Hope’s affiliated group of organizations includes Translational Genomics Research Institute and AccessHope TM . For more information about City of Hope, follow us on Facebook , X , YouTube , Instagram and LinkedIn .
Journal of the National Comprehensive Cancer Network
Technology-Enabled Patient and Physician Activation to Enhance Skin Cancer Screening After HCT (TEACH Study): A Randomized Controlled Trial
6-Aug-2026