33980 Skin cancer risk factors and screening among Asian Americans: Pooled cross-sectional surveys from 2000 to 2015

Abstract

Asian Americans are underrepresented in health disparities research and little is known about skin cancer risk factors and screening among Asian Americans. We examined sunburns, sun-protective behaviors, indoor tanning, and total body skin examinations (TBSE) among Asian Americans as compared with non-Hispanic Whites. Cross-sectional survey data from the National Health Interview Survey were pooled from 2000-2015. Multivariate logistic regression models examined associations of skin cancer risk factors and screening with race. Models were weighed to provide nationally representative estimates and adjusted for survey year, sociodemographic factors, cancer-related health behaviors, and skin cancer history. Overall, 132,583 non-Hispanic Whites and 10,102 Asian Americans were included (2083 Chinese; 1928 Asian Indian; 2307 Filipino; 3784 other Asian). Asian Americans were more likely to seek shade, wear long clothing to ankles, and wear long-sleeved shirts but less likely to sunburn, apply sunscreen, tan indoors, and receive TBSE than non-Hispanic Whites (each P < .05). Asian Indians were less likely to sunburn (adjusted odds ratio 0.54; 95% CI 0.39-0.75) and more likely to wear long-sleeved shirts (1.54; 1.22-1.95) or long clothing to ankles (1.91; 1.53-2.40) than Chinese participants. Filipinos were more likely to engage in 1+ sun-protective behavior (1.30; 1.08-1.56) than Chinese participants. Limitations included self-reported data and no adjustment for skin tone. Asian American sun-protective behaviors may not be influenced by perceived skin cancer risk. Direct comparisons among Asian Americans subgroups revealed differences utilizable through culturally tailored interventions. Oversampling of Asian Americans will facilitate disaggregated analyses that may unmask health disparities among Asian American subgroups.