Community outreach in vulnerable populations: Skin cancer screening for firefighters.

Abstract

e21587 Background: Firefighters have both an increased risk (21%) and 20-year younger median age (42) at diagnosis of melanoma compared to the general population. The World Health Organization classifies firefighters’ occupational exposures as "carcinogenic to humans," but there is limited knowledge regarding sun protection habits, skin cancer history, and community outreach in this at-risk population. Methods: Free, full-body skin examinations conducted by board-certified dermatologists using the American Academy of Dermatology’s SPOT Skin CancerTM screening form were offered to firefighters from 26 cities and towns in Massachusetts on two separate days in August 2021 and October 2022. Data from the screening form and subsequent skin biopsy results were obtained and reported. Results: Of 195 firefighters screened, 30 (15.4%) were referred for biopsy. All were white males, mean age was 44.7 years, 26.7% had prior tanning bed exposure, 80% had prior blistering sunburns, 20% used sunscreen regularly, 86.7% did not have a regular dermatologist, and 6.7% had a history of keratinocyte-based skin cancer. Nineteen (63.3%) had biopsies, most frequently on the back or face, which resulted in three nodular basal cell carcinomas and 11 dysplastic nevi (seven moderate-to-severe). Conclusions: Firefighters are an underrecognized vulnerable population for the development of skin cancer. Community outreach in the form of free skin cancer screenings is a successful model for increasing awareness and early diagnosis of skin cancer among this population. In addition to providing access to care, community screenings offer tailored educational opportunities that promote skin cancer prevention in this high-risk group.