Skin cancer prevalence in farm workers in Spain

Abstract

Solar ultraviolet radiation (UVR) is one of the main risk factors for non-melanoma skin cancer. In Spain, 11% of the population are outdoor workers. Farmers are among the outdoor workers with the highest levels of chronic sun exposure. To study the prevalence of skin cancer in farmers and evaluate their photoprotection habits. We performed an observational cross-sectional prospective study of farmers who completed a validated questionnaire on UVR exposure and protective behaviour and underwent a skin examination and skin colorimetry overseen by a dermatologist. The study population consisted of 215 farm workers (84.4% male; mean age: 65.8 ± 14 years; mean years working: 45 ± 18). Actinic keratosis (AK) was detected in 41.4%, basal cell carcinoma (BCC) in 9.8%, and squamous cell carcinoma (SCC) in 1.4%. The most frequent photoprotection measure was the shade (69.3%). Photoaging type was significantly associated with the presence of AK and BCC, and Olson Grade II and III AK lesions correlated with SCC. The number of nevi on the lower extremities was the only predictor of the appearance of BCC. Photoprotection measures were not regularly used by most farm workers and the prevalence of skin cancer lesions was high. The findings underscore the need to improve photoprotection habits and early detection of skin cancer in this population.