Sylvester Comprehensive Cancer Center

UM Survey Reveals Disparities in Skin Cancer Knowledge Among Miami High School Students


Researchers from the University of Miami Miller School of Medicine surveyed students at a Miami-Dade County public high school and found white Hispanic teens were more likely to use tanning beds and less likely to consider themselves at risk for skin cancer or protect themselves from the sun than white non-Hispanic teens. The findings were published in the August issue of Archives of Dermatology, one of the JAMA/Archives journals.*

Exposure to the sun’s ultraviolet (UV) rays is a major risk factor for melanoma and non-melanoma skin cancers, and the majority of lifetime exposure occurs by age 18, according to background information in the article. White Hispanics have a lower rate of skin cancer than white non-Hispanics, but are more likely to be diagnosed at a later stage. This suggests that “there are differences in knowledge and behavior related to the prevention of skin cancer in white Hispanic and white non-Hispanic populations; therefore, we hypothesize that these differences may exist in students and may be related to early acquisition of knowledge,” the authors write.

Researchers from the Departments of Dermatology and Cutaneous Surgery and Epidemiology and Public Health, along with the University of Miami Sylvester Comprehensive Cancer Center, surveyed 369 Miami-Dade County high school students (221 white Hispanics and 148 white non-Hispanics) about their skin cancer knowledge, perceived risk and sun protection behaviors. In addition, students were asked questions related to burning and tanning after sun exposure to determine their skin type.

Compared with white non-Hispanic students, white Hispanic students were:

  • More likely to tan deeply (44.2 percent vs. 31 percent)
  • 60 percent less likely to have heard of skin self-examination and 70 percent less likely to have been told how to perform it
  • About 1.8 times as likely to never or rarely wear sun-protective clothing
  • About twice as likely to never or rarely use sunscreen\
  • Less likely to think they had an average or above-average risk for skin cancer (23.1 percent vs. 39.9 percent)
  • 2.5 times as likely to have used a tanning bed in the previous year

“These differences between white Hispanic and white non-Hispanic students remained significant after age, sex, sun sensitivity and family history of skin cancer were controlled for,” the authors write.

“Even after controlling for skin cancer risk factors, white Hispanic students had differences in knowledge and behavior related to skin cancer protection. This suggests delayed diagnosis and the rise on skin cancer in Hispanics may be due to lack of knowledge,” said Robert S. Kirsner, M.D., Ph.D., professor and vice chairman of the Department of Dermatology and Cutaneous Surgery and the study’s senior author. “This provides opportunities for intervention.”

In 2006, Dr. Kirsner and his colleagues published a study in Archives of Dermatology that found melanoma is diagnosed later among blacks and Hispanics compared to white patients, which suggests a lack of awareness among minorities about their melanoma risk. When melanoma is caught at an early stage before it has spread the 5-year survival rate is 98 percent. If it isn’t caught until it has metastasized, or spread far from where it began, survival dwindles to 16 percent.

*This publication/presentation described was supported by Grant Number 5 UO1 CA86117-05 to Redes En Accion from the National Cancer Institute. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

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