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Minority, immigrant populations face barriers to skin cancer prevention

Minority, immigrant and uninsured patients indicated barriers to skin cancer prevention including lack of knowledge and the belief that dark skin was protective, according to study results recently published in JAMA Dermatology.

Researchers conducted a 23-question survey in English, Spanish or Haitian Creole of 206 people (mean age, 43 years; 75.7% women) who were uninsured, living at least 200% below the federal poverty level and attending a large free medical clinic in Florida. The survey measured their skin cancer risk perception, knowledge, sun-protective behaviors and barriers and desirable outreach levels.

The study participants were adults without a scheduled appointment who were recruited from the waiting room. Likert-type scales, true or false, and yes or no answers were used in the survey.

The largest proportion of survey participants were immigrants from Central America (37.9%), Mexico (27.7%), South America (14.1%) and the Caribbean (12.1%). Most (72.8%) spoke Spanish, 9.7% spoke Creole and 7.8% spoke English. Pigment levels, graded on a 6-point scale, varied: 65.7% of participants had high-risk, 24.5% had medium-risk and 9.8% had low-risk skin type.

Almost a quarter of the participants (24.5%) reported never having heard of skin cancer or melanoma. More than half (58.2%) had never or rarely conducted a skin self-examination. Increased frequency of skin checks correlated with higher education (P < .001).

Eighty respondents (39.6%) reported they were “very unlikely” or “unlikely” to get skin cancer in their lifestyle, and 20.7% believed that people with dark skin could not get skin cancer.

Low or inconsistent sun protective behavior was categorized for 75.7% of respondents, with “using sun protection is too hot” (39.3%) and “I forget” (37.7%) among common barriers to sun-protective behaviors.

The majority of participants (87.9%) indicated they wanted to learn more about how to prevent skin cancer. Most popular outreach methods were watching a video and text messaging.

“Our results, coupled with the mounting evidence of increased skin cancer mortality in minorities, support a strong need for more research-tested intervention programs in underserved communities,” the researchers concluded. “Specifically, interventions will need to include primary, secondary, and tertiary prevention to have an impact on skin cancer disparities.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.