Skin cancer risk perceptions: A comparison across ethnicity, age, education, gender, and income

Buster, Kesha J.; You, Zhiying; Fouad, Mona N.; Elmets, Craig A.

doi:10.1016/j.jaad.2011.05.021

Cited by 116 publications

(101 citation statements)

References 57 publications

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“…This is because tan skin is found not only in caucasian populations but also in individuals of Asian, Hispanic, African and Afro-American descent, some of whom perceive themselves to be at a lower risk for developing sunburn or skin cancers. 35,36 However, sunburn has been reported among Hispanic black, Asian/Pacific islanders and American Indians/Alaska natives. 37 Furthermore, even though skin cancers are less frequent in nonwhite/darkly pigmented individuals, it is often associated with increased morbidity and mortality due to a lack of awareness of these diseases among these populations, associated with a delay in diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Variations in skin colour and the biological consequences of ultraviolet radiation exposure

2013

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SummaryHarmful consequences of sun exposure range from sunburn, photoageing and pigmentary disorders to skin cancer. The incidence and extent of these detrimental effects are largely due to the degree of constitutive pigmentation of the skin. The latter can be objectively classified according to the individual typology angle (°ITA) based on colorimetric parameters. The physiological relevance of the ITA colorimetric classification was assessed in 3500 women living in various geographical areas. Furthermore, in order to understand the relationship between constitutive pigmentation and ultraviolet radiation (UVR) sensitivity, we worked on ex vivo human skin samples of different colour exposed to increasing UVR doses. For each sample we defined the biologically efficient dose (BED), based on the induction of sunburn cells, and analysed UVR-induced DNA damage (cyclobutane thymine dimers, CPD). We found a significant correlation between ITA and BED. We also found a correlation between ITA and DNA damage. As the epidermal basal layer also hosts melanocytes and in order to analyse the relationship between skin colour and DNA damage occurring specifically within this cell type, we performed double staining for CPD and tyrosinase-related protein (TRP) 1, a key enzyme in melanin synthesis. We found that DNA damage within melanocytes depends on ITA. Taken together our results may explain the higher risk of lighter skin types developing skin cancers, including melanoma, as well as the development of pigmentary disorders in moderately pigmented skin. They show that skin classification based on ITA is physiologically relevant (as it correlates with constitutive pigmentation) and further support the concept of a more personalized approach to photoprotection that corresponds to a particular skin colour type's sensitivity to solar UVR.What's already known about this topic?• Sun exposure sensitivity is largely dependent on the degree of skin constitutive pigmentation.What does this study add?• The individual typology angle (ITA)-based skin colour classification correlates with constitutive pigmentation and is physiologically relevant in different geographical areas.• It may help identify differential responses to ultraviolet radiation (UVR) exposure that correspond to particular skin colour type's UVR sensitivities.• It supports the concept of personalized photoprotection.Harmful consequences of sun exposure range from sunburn, photoageing and pigmentary disorders to skin cancer. The incidence and extent of these detrimental effects is largely dependent on the degree of constitutive pigmentation of the skin.1-6 Human skin colour is determined by the total quantity of melanin, the proportion between the brown-black eumelanin

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Section: Discussionmentioning

confidence: 99%

Variations in skin colour and the biological consequences of ultraviolet radiation exposure

2013

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“…Buster et al 37 found that people who were less educated, elderly, or black were more likely to perceive themselves as being at low risk for developing skin cancer and were less inclined to receive skin examinations. In their survey of more than 500 patients who survived cutaneous melanoma, Pollitt et al 5 found that lower levels of education were associated with decreased perception and knowledge of risk for cutaneous melanoma.…”

Section: Barriers Related To Povertymentioning

confidence: 99%

“…37,56–58 Blacks 37,50,59 and Hispanics 59–62 perceive themselves to be at very low risk for developing skin cancer. A study by Pichon et al 50 observed no difference in sunscreen use among blacks who reported they perceived a high risk of skin cancer versus those who perceived no risk of skin cancer.…”

Section: Barriers Related To Culturementioning

confidence: 99%

Social Determinants of Racial and Ethnic Disparities in Cutaneous Melanoma Outcomes

et al. 2014

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Background This article sought to elucidate how aspects of poverty and culture may contribute to race- and ethnicity-based disparities in cutaneous melanoma outcomes. Methods We identified published studies addressing the social determinants of melanoma. Selected review articles included US-based studies comprised of patients representing adults, children, and adolescents. Results African Americans and Hispanics diagnosed with cutaneous melanoma are more likely to present with more advanced stages of disease at diagnosis and have higher rates of mortality than their nonminority counterparts. These disparities may be a consequence of economic, social, and cultural barriers such as low income, public forms of health insurance, lower levels of education, lower levels of melanoma awareness and knowledge, and lower rates of participation in melanoma screening. No studies in the literature examined the potential impact of social injustice, English proficiency, immigrant status, and health literacy. Conclusions Substantial gaps exist in our knowledge of the pathways linking social determinants and race- and ethnicity-based disparities in melanoma. More studies are warranted to inform the development of effective interventions aimed at narrowing inequities and improving cutaneous melanoma outcomes among minority populations.

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“…This may stem from lower levels of perceived skin cancer risk among SFGH participants, diff erences in access to primary care and dermatologic follow-up, or decreased skin cancer education by health care providers, compared with Diller participants. 40,41 In addition to the disparities we observed in cancer screening practices, we also note diff erences between hospitals in breast cancer detection and treatment. Although lump palpation was the most frequent method of detection at both hospitals, mammographically detected breast cancer was more common at Diller compared with SFGH.…”

Section: Discussionmentioning

confidence: 70%

Genetic Counseling, Cancer Screening, Breast Cancer Characteristics, and General Health among a Diverse Population of BRCA Genetic Testers

Beattie¹,

Copeland²,

Fehniger³

et al. 2013

hpu

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Outcomes after genetic testing for hereditary breast and ovarian cancer (HBOC) syndrome have not been well studied in underserved populations. We surveyed 1,123 BRCA testers from a genetic counseling program serving an academic cancer center (n=1,045) and a public county hospital (n=78) a median of 3.7 years after testing for mutations in BRCA1 and BRCA2 (breast cancer susceptibility genes). We compared genetic counseling outcomes, cancer screening rates, and self-reported general health. We found no differences in genetic counseling outcomes between hospitals. Breast cancer screening rates were similarly high at both hospitals, which are warranted in this high-risk population. Screening rates for ovarian, colon, and skin cancer were significantly lower in participants from the public hospital. BRCA results were not a predictor of general health at either hospital. When creating a genetic counseling program that serves women in different hospital settings, providers should emphasize guidelines-based screening recommendations for all patients.

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Skin cancer risk perceptions: A comparison across ethnicity, age, education, gender, and income

Cited by 116 publications

References 57 publications

Variations in skin colour and the biological consequences of ultraviolet radiation exposure

Variations in skin colour and the biological consequences of ultraviolet radiation exposure

Social Determinants of Racial and Ethnic Disparities in Cutaneous Melanoma Outcomes

Genetic Counseling, Cancer Screening, Breast Cancer Characteristics, and General Health among a Diverse Population of BRCA Genetic Testers

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