Skin protection behaviors differ among Asian American subpopulations

Skin protection behaviors such as wearing long sleeves or using sunscreen varied among Asian American individuals who identified as Asian Indian, Chinese, Filipino or “other Asian,” according to a study.

“Asian American individuals are the fastest growing racial group in the U.S. but remain underrepresented in health disparities research, including research on skin cancer risk factors and screening,” Krittin J. Supapannachart, MPH, of the department of dermatology at Emory University School of Medicine in Atlanta, and colleagues wrote.

They suggested that a deeper understanding of preventable risk factors for skin malignancy, along with greater awareness of screening protocols, may reveal unmet needs in this population.

In the cross-sectional study, factors such as sunburn, sun-protection behaviors, indoor tanning habits and total body skin examinations (TBSEs) underwent analysis. Outcomes and habits for Asian American subgroups were compared with one another and with those observed in non-Hispanic White populations.

Data from the National Health Interview Survey for years 2000, 2005, 2010 and 2015 were used. The study included findings for 84,030 individuals who self-identified as Asian Indian, Chinese, Filipino, non-Hispanic White and Other Asian. The cohort included 5,694 (6.8%) Asian American individuals and 78,336 (93.2%) non-Hispanic White individuals. Among the Asian American group, 21% were Asian Indian, 19.4% were Chinese, 23.5% were Filipino and 36.1% were “other Asian.”

Primary outcome measures included any sunburn within the last year; any indoor tanning use within the last year; any TBSE at any point; and use of sun protective measures such as sunscreen, staying under shade, wearing a cap most of the time or wearing long sleeves, long pants or a hat.

Results showed that participants in all Asian American subgroups were more likely than their non-Hispanic White counterparts to engage in a number of the behaviors of interest, including seeking shade and wearing long-sleeved shirts or long pants. Conversely, Asian Americans were less likely than their comparators to have had a sunburn within the last year, apply sunscreen, use indoor tanning beds or have had a TBSE.

Looking at specific populations, Asian Indian participants were less likely than their Chinese American counterparts to use sunscreen (adjusted OR = 0.55; 95% CI, 0.41-0.74) or wear a hat (aOR, 0.53; 95% CI, 0.37-0.76). Chinese Americans were more likely than Asian Indians to wear a long-sleeved shirt (aOR = 1.89; 95% CI, 1.52-2.33) or long clothing that reached the ankles (aOR = 1.56; 95% CI, 1.28-1.9).

“The results of this cross-sectional study found that disaggregated comparisons among Asian American individuals demonstrated differences in skin cancer risk factors that may be used to identify high-risk subgroups and inform culturally aware counseling when indicated,” the researchers wrote. “Future studies should further sample Asian American individuals to evaluate for potential masked health disparities through disaggregated analysis.”