Skin cancer risk perceptions: A comparison across ethnicity, age, education, gender, and income

Background: Studies of noncutaneous and cutaneous malignancies support the hypothesis that poor risk-perception status contributes to health disparity. Objective: We evaluated skin cancer (SC) risk perceptions across race and other demographic markers using the Health Information National Trends Survey (HINTS) and compared them to discover differences in perception that may contribute to the disparities in SC diagnosis and treatment. Methods: Respondents with no history of SC were randomly selected to answer questions assessing perceived risk and knowledge of preventive strategies of SC. Logistic regression was performed to identify associations between perceptions of SC and demographic variables including self-described race, age, sex, education, income, and health insurance status. Results: Blacks, the elderly, and people with less education perceived themselves as at lower risk of developing SC. They, along with Hispanics, were also more likely to believe that one cannot lower their SC risk and that there are so many different recommendations on how to prevent SC that it makes it difficult to know which ones to follow. Lower education also correlated with greater reluctance to have a skin examination. Limitations: HINTS is a cross-sectional instrument, thus it only provides a snapshot of SC perceptions. Conclusion: Uncertainty and altered perceptions are more common in the SC risk perceptions of ethnic minorities, the elderly, and those with less education. These are the same groups that are subject to disparities in SC outcomes. Educational programs directed at these demographic groups may help to reduce the SC-related health disparities. (J Am Acad Dermatol 2012;66:771-9.)