Prevalence and Predictors of Recent Skin Examination in a Population-Based Twin Cohort

Abstract

Background The incidence of melanoma is increasing worldwide. Guidelines for clinical skin exam for improving early diagnosis of melanoma remain inconsistent, and current data on factors associated with regular skin screening on a population basis are limited. Methods We used self-reported data from 50,044 members of the California Twin Program, a population-based cohort of twins born in California between 1908 and 1982, to identify prevalence and determinants of recent clinical screening for skin cancer. Results Prevalence of skin examination was higher than national estimates, with 32% of respondents of all ages reporting ever having skin examination. Socio-demographic and constitutional risk factors including white race, educational attainment, marital status, and number of large moles were strongly associated with recent screening, as were individual and family history of skin cancer. Lower socioeconomic status, racial/ethnic minority status, and paradoxically, frequent UV-related risk behaviors in adulthood were associated with a lower likelihood of recent screening. Conclusions As the evidence concerning the efficacy of skin examination continues to evolve, attention should be paid to motivators and barriers of screening, particularly in high-risk subgroups where lack of screening may contribute to disparate rates of thicker melanomas and lower survival. Impact Our results demonstrate the need for prevention strategies targeted to specific at-risk groups to increase earlier detection leading to improved outcomes.

Physician skin cancer screening among U.S. military veterans: Results from the National Health Interview Survey

“…This figure is higher than the overall rate of 21.3% in the U.S. population in 2015 [ 10 ]. Higher rates of screening were found among individuals with one or more skin cancer risk factors, which is consistent with research conducted with non-veteran populations [ 10 , 12 ].…”

Female Estrogen-Related Factors and Incidence of Basal Cell Carcinoma in a Nationwide US Cohort

“…Our data do not contain a direct measure of skin cancer screening. To account for potential surveillance bias among users of MHT, we examined the following correlates of skin cancer screening: education, age, marital status, constitutional characteristics (hair color and skin complexion), 27 – 29 and dental x-rays because dental visits are associated with access and use of preventative care. 19 – 22 Missing values were coded as separate categories and included as indicator variables in the models.…”

Skin Cancer Risk Reduction Behaviors Among American Indian and Non-Hispanic White Persons in Rural New Mexico

“…In addition, the significantly lower frequency of physician skin checks reported by American Indian individuals ( P < .001) in this study may be associated with the higher melanoma mortality rates among the American Indian population. Although there is a paucity of data for comparison, a similar study found non-Hispanic white people to be more likely than nonwhite individuals to have physician skin checks . Data from 1999 to 2006 showed high percentages of advanced, thicker melanomas among nonwhite compared with white persons .…”

“…Although there is a paucity of data for comparison, a similar study found non-Hispanic white people to be more likely than nonwhite individuals to have physician skin checks. 4 Data from 1999 to 2006 showed high percentages of advanced, thicker melanomas among nonwhite compared with white persons. 4,5 The higher percentage of Related article page 1342 A 2-sample t test indicated a statistically significant difference in mean sun-behavior scores between American Indian and non-Hispanic white participants (P < .001) with overall sun-behavior scores higher among non-Hispanic white participants.…”

“…4 Data from 1999 to 2006 showed high percentages of advanced, thicker melanomas among nonwhite compared with white persons. 4,5 The higher percentage of Related article page 1342 A 2-sample t test indicated a statistically significant difference in mean sun-behavior scores between American Indian and non-Hispanic white participants (P < .001) with overall sun-behavior scores higher among non-Hispanic white participants. Boxes indicate 25th and 75th percentiles; horizontal line in the box, group median; error bars, minimum and maximum, excluding outliers; and solid circles, outliers.…”