Warning: New Skin Cancer Study Finds Outdoor Workers Are Less Likely To Get Screened For Skin Cancer

While occupational risks are
inherent in many jobs, workers who make a living toiling in the sun face an
increased threat of skin cancer from repeated overexposure to the sun's
harmful ultraviolet (UV) rays. Now, new research finds that workers who
need skin exams the most by nature of their occupation -- such as
construction, forestry, fishing and farming workers -- are the least likely
to get them.



In the study published online in the Journal of the American Academy of
Dermatology entitled "Reported skin cancer screening of U.S. adult
workers," dermatologist Robert S. Kirsner, MD, PhD, FAAD, professor and
vice chairman of the departments of dermatology and cutaneous surgery at
the University of Miami Miller School of Medicine in Miami, and his
colleagues used the National Health Interview Survey (NHIS) data from 2000
and 2005 to estimate the percentage of U.S. workers who had ever had a
thorough skin examination in their lifetime or during an appointment with a
primary health care provider in the past 12 months.



"Previous studies have shown that total-body screening examinations are
not frequently performed during routine health examinations by primary care
physicians, even among potentially high-risk populations," said Dr.
Kirsner. "As dermatologists, we know that the early detection of skin
cancer by routine skin examinations is crucial in successfully treating
this potentially life-threatening condition -- particularly for workers
routinely exposed to harmful ultraviolet light. This study shows that
workers who need careful monitoring for skin cancer due to the nature of
their jobs are less likely to receive skin exams than workers in low-risk
occupations."



Conducted by the National Center for Health Statistics (NCHS), the NHIS
is an annual, cross-sectional in-person household survey of U.S. workers.
In 2000 and 2005, the Cancer Control Module was included as part of the
NHIS and included questions on skin examinations that were administered to
19,702 and 18,422 employed participants, respectively. Questions included
"Have you ever had all of your skin from head to toe checked for cancer
either by a dermatologist or some other kind of doctor?" and "When did you
have your most recent skin exam?"



Dr. Kirsner explained that data of all participants who reported a
full-body skin examination were grouped into two categories -- those who
received a skin exam in the last 12 months and ever in their lifetime.
Workers also were asked about their sun-protection behavior, if they
reported going out in the sun for an hour or more, and, from their
responses, were classified as "sun exposed" for the purposes of the study.



In addition, detailed employment information was coded by occupation
and industry for all participants aged 18 years or older employed during
the time of the survey. Occupations were grouped into four standard
occupational categories -- white-collar workers; service workers; farming,
fishing, and forestry workers; and blue-collar workers. Workers were then
subsequently grouped into eight industrial sector classifications --
agriculture, forestry, and fishing; mining; construction; manufacturing;
wholesale and retail trade; transportation, warehousing, and utilities;
services; and health care and social assistance.
















"When we examined the data for the 38,124 total worker participants
interviewed from the 2000 and 2005 Cancer Control Supplements, we found
that the prevalence of both lifetime and 12-month skin examinations was
low," said Dr. Kirsner. "Only 15 percent of all U.S. workers reported ever
receiving a skin examination during their lifetime, and only 8 percent of
those who also had seen a health care provider in the past year reported
that they had received a skin exam during that time."



In addition, the data clearly showed that the rate of reporting skin
cancer screening was lowest for high-risk occupations most likely to
experience increased sun exposure. Specifically, in the 2000 and 2005
Cancer Control Modules, the prevalence of 12-month skin examinations among
those who had seen a physician in the past year was lowest among farm
workers (5.8 percent and 1.6 percent, respectively) and blue-collar workers
(3.9 percent and 4.9 percent, respectively).



"When we analyzed the data by industry sectors, we concluded that
agriculture, forestry, fishing, and construction workers reported the
lowest rate of skin exams in 2000," said Dr. Kirsner. "Although the number
of agriculture, forestry and fishing workers reporting a skin exam
increased from 2000 to 2005 -- from 4.2 percent to 13.6 percent -- the
prevalence of skin exams among construction workers stayed essentially the
same, from 5.2 percent to 5.6 percent."



Dr. Kirsner added that occupational groups at increased risk for
exposure to UV light on the job were less likely to have ever received a
skin examination in their lifetime than the average U.S. worker (15
percent). This included farm operators and managers (10 percent), farm
workers and other agricultural workers (7 percent), forestry and fishing
occupations (3 percent), construction and mining trades (8 percent), and
construction laborers (8 percent).



"Socioeconomic factors also were significant predictors of having a
skin exam in the past year," said Dr. Kirsner. "Specifically, younger black
or Hispanic women with no health insurance, who were service, farm or
blue-collar workers, and who did not use sun protection were the least
likely to report ever having been screened for skin cancer. All patients,
especially those that have occupations where they are exposed to UV light,
should request that their physician provide skin exams during their routine
exams."



"In addition, developing and implementing local community health fairs
that include screening programs targeting high-risk workers who are
reporting low skin examination rates could help reverse this alarming
trend," commented Dr. Kirsner. "One way to receive a free screening is
through the Academy's National Melanoma/Skin Cancer Screening Program,
where dermatologists volunteer to provide free skin cancer screenings in
their communities. The public can visit aad to find a free
skin cancer screening in their area."



For more information about skin cancer, please visit the SkinCancerNet
section on skincarephysicians, a Web site developed by
dermatologists that provides patients with up-to-date information on the
treatment and management of disorders of the skin, hair and nails.



Headquartered in Schaumburg, Ill., the American Academy of Dermatology
(Academy), founded in 1938, is the largest, most influential, and most
representative of all dermatologic associations. With a membership of more
than 15,000 physicians worldwide, the Academy is committed to: advancing
the diagnosis and medical, surgical and cosmetic treatment of the skin,
hair and nails; advocating high standards in clinical practice, education,
and research in dermatology; and supporting and enhancing patient care for
a lifetime of healthier skin, hair and nails.


American Academy of Dermatology

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