Prevalence and Correlates of Skin Cancer Screening among Middle-aged and Older White Adults in the United States

Abstract

Background Total skin examinations performed by a physician have the potential to identify skin cancers at an early stage, when they are most amenable to successful treatment. This study examined the prevalence rates of, and factors associated with, receipt of a total skin examination by a dermatologist or other doctor during the past year. Methods The participants were 10,486 white men and women aged 50 years and older drawn from a random sample of 31,428 adults aged 18 years and older who took part in the 2005 National Health Interview Survey (NHIS). The data were collected via in-person interviews, and participants answered questions regarding their receipt of total skin examinations, their demographic characteristics, health and healthcare access, receipt of other cancer screenings, and personal and family history of skin cancer. Results Sixteen percent of men and 13% of women reported having a skin examination in the past year. The factors associated with lowest skin examination rates in multivariable analyses included younger age (50–64 years), lower education level, lack of screening for colorectal, breast (women only), and prostate cancers (men only), and lack of a personal history of skin cancer. Conclusions Rates of having a skin examination in the past year were low among men and women and among all sub-groups. Systematic efforts are needed to increase screening rates among higher risk individuals. Physicians should be particularly aware of the need to consider skin cancer screening examinations for their male, elderly patients, as well as individuals with less education.

Improving Skin Cancer Knowledge Among Nurse Practitioners

“…In 2003, the U.S. Preventative Services Task Force thought there was not enough evidence to support educating patients about the importance of sun protection (Saraiya et al, 2003). They have since changed their perspective and recommend sun-protective behaviors such as using sunscreen, wearing protective clothing, avoiding peak hours of UV radiation, and avoiding tanning beds to decrease the incidence of skin cancer (Coups, Geller, Weinstock, Heckman, & Manne, 2010;Lin, Eder, & Weinmann, 2011).…”

Reducing mortality in individuals at high risk for advanced melanoma through education and screening

“…5 We highlight emerging incidence and mortality trends, provide data supportive of public health interventions to reduce melanoma mortality, and explore options for reducing mortality including screening trials and public and professional education to promote early detection of disease.…”

“…5 Middle-aged and older men, persons of lower SES, and individuals given the diagnosis of the nodular melanoma (NM) subtype are at greatest risk of advanced disease.…”

Disproportionate Burden of Melanoma Mortality in Young US Men

“…Behavioral factors include women's greater propensity to examine their own skin, their opportunities for receiving medical and preventive care, and the facileness with which they engage physicians in discussions about preventive care or request skin examinations within a routine visit to their primary care physician. [2][3][4] These factors all compete as possible reasons for this disparity, but factors related to tumor biology may come into sharper relief for younger people who make fewer visits to primary care physicians who are well known to discover thinner melanoma than the patient or their significant other.Where might biological differences in male vs female melanoma arise? An obvious possibility could be distinctive exposure patterns to UV radiation.…”