Skin Cancer Risk Factors and Screening

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• This survey-based cross-sectional analysis investigated the sun-protective behaviors and skin cancer risk factors of self-identified Asian Indian, Chinese, Filipino, and other Asian participants and compared them with those of a non-Hispanic White reference group. Compared with non-Hispanic White individuals, Asian Americans were more likely to seek shade and wear sun-protective clothing and less likely to experience sunburns, apply sunscreen, or undergo total-body skin examinations.

• Sun-protective behaviors and skin cancer risk factors differ between Asian American and non-Hispanic White individuals, with much variance between Asian American subgroups.

–  Joshua R. Ortego, MD

This abstract is available on the publisher's site.

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Importance

Asian American individuals are the fastest growing racial group in the US but remain underrepresented in health disparities research, including research on skin cancer risk factors and screening. Improved understanding of preventable skin cancer risk factors and screening may demonstrate unmet needs among Asian American individuals.

Objective

To examine sunburns, sun-protective behaviors, indoor tanning, and total body skin examinations (TBSEs) for skin cancer screening among Asian American subgroups compared with non-Hispanic White individuals.

Design, Setting, and Participants

The National Health Interview Survey is a nationally representative cross-sectional survey in the US that assesses health behaviors. Self-identified Asian Indian, Chinese, Filipino, non-Hispanic White, and other Asian respondents from survey years 2000, 2005, 2010, and 2015 were included. Data were analyzed from July to November 2021.

Main Outcomes and Measures

Any sunburn within the last year; sun-protective behaviors included applying sunscreen, staying under shade, wearing long-sleeved shirts, wearing long clothing to the ankles, wearing hats, and wearing caps most of the time or always when out in the sun; any indoor tanning within the last year; any TBSE ever.

Results

Of 84 030 participants, 5694 were Asian American (6.8%) and 78 336 (93.2%) were Non-Hispanic White; of these individuals, 1073 (weighted prevalence, 21.0%) were Asian Indian, 1165 (19.4%) Chinese, 1312 (23.5%) Filipino, and 2144 (36.1%) Other Asian. All Asian American subgroups were more likely to seek shade, wear long clothing to the ankles, and wear long-sleeved shirts but less likely to sunburn, apply sunscreen, tan indoors, and receive TBSE than Non-Hispanic White individuals. Asian Indian individuals were less likely than Chinese participants to apply sunscreen (adjusted odds ratio [aOR], 0.55; 95% CI, 0.41-0.74) or wear a hat (aOR, 0.53; 95% CI, 0.37-0.76) and more likely to wear long-sleeved shirts (aOR, 1.89; 95% CI, 1.52-2.33) or long clothing to the ankles (aOR, 1.56; 95% CI, 1.28-1.90).

Conclusions and Relevance

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. Future studies should further sample Asian American individuals to evaluate for potential masked health disparities through disaggregated analysis.

JAMA Dermatology

Skin Cancer Risk Factors and Screening Among Asian American Individuals

JAMA Dermatol 2022 Jan 26;[EPub Ahead of Print], KJ Supapannachart, SC Chen, Y Wang, H Yeung 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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