Survey reveals disparities in skin cancer knowledge, protection among high school students

In a survey of Florida high school students, 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, according to a report 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.

Fangchao Ma, M.D., Ph.D., of the University of Miami Miller School of Medicine, and colleagues surveyed 369 Florida 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.

“Our survey indicated that a significantly lower proportion of white Hispanics than white non-Hispanics wore sun-protective clothing or used sunscreen with a sun protection factor of 15 or higher, regardless of skin sensitivity to the sun,” they conclude. “Such gaps indicate that there is a need to include white Hispanic students in skin cancer prevention programs targeting young persons.”

(Arch Dermatol. 2007;143(8):983-988. Available pre-embargo to the media at www.jamamedia.org.)

Editor’s Note: This study was supported in part by the National Institutes of Health through the Redes En Acción program. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Teens tan because they like the effect it has on their appearance, and showing how tanning can damage the skin has been shown to help change sun-related behavior in young people, writes Ann F. Haas, M.D., of the National Coalition for Sun Safety, Sacramento, Calif., in an accompanying editorial.

“The current strategy consists of providing acceptable, healthy alternatives to tanning (highlighting the positive features of the alternatives), emphasizing the negative appearance aspects of tanning and working to change the social norms regarding the ‘tanned-is-healthy-and-attractive’ message,” Dr. Haas writes. “The message should be sex and age appropriate and include a cross section of the adolescent community, including family, school settings, health care providers and the media.”

(Arch Dermatol. 2007;143(8):1058-1061. Available pre-embargo to the media at www.jamamedia.org.)

Editor’s Note: Please see the article for additional information, including author contributions and affiliations, financial disclosures, funding and support, etc.