Racial differences in skin cancer awareness and surveillance practices at a public hospital dermatology clinic

Abstract

Patients from ethnoracial minority groups have lower incidence rates of melanoma compared with whites, but are more likely to have advanced melanomas at diagnosis and lower survival. Infrequent skin cancer screening and poor melanoma awareness may contribute to these disparities. The purpose of this survey study was to evaluate skin cancer surveillance behaviors and awareness among patients attending a dermatology clinic at a public hospital in New York City. Surveys were administered to 152 patients from April to June 2012. In all, 16% of patients previously had a total body skin examination for cancer, 11% were taught by a health care practitioner how to perform skin self-examinations, and 15% perform skin self-examinations. More whites had a total body skin examination compared with minorities (49% vs 5%). Only 33% of patients previously given a diagnosis of skin cancer performed skin self-examinations. Patients possessed a poor ability to recognize features suspicious for melanoma, with minorities (especially Hispanics) performing worse than whites. Small sample size is a limitation. Few patients engage in skin cancer screening behaviors and their knowledge about melanoma is poor, with minorities demonstrating lower understanding than whites. Our findings emphasize the need for improved patient education about characteristics of melanoma, regardless of race.