Workers Most in Need of Skin Exams Are Least Often Screened

New research in the Journal of the American Academy of Dermatology suggests that workers who need skin exams the most, by the nature of their occupations -- such as construction, forestry, fishing, and farming workers -- are the least likely to get them. In the study, titled "Reported skin cancer screening of U.S. adult workers," Dr. Robert S. Kirsner, Ph.D., FAAD, professor 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 Kirsner, who is also vice chairman of the university's departments of dermatology and cutaneous surgery. "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), 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?"

Kirsner explained that data of all participants who reported a full-body skin examination were grouped into two categories--those who've received a skin exam in the last 12 months and hose who've received a skin exam 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. "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," Kirsner said. "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."

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)

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).

For more information, visit www.aad.org.

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