Skin Cancer in Hispanics in the United States.

The Hispanic population has been the principal driver of U.S. demographic growth in the last two decades. In 2016, Hispanics accounted for 18% of the nation’s population and were the second-largest racial or ethnic group behind whites making the people of Hispanic origin the nation's largest ethnic or racial minority. Non-melanoma skin cancer (NMSC) is the most common malignancy in the U.S. with over 3.5 million diagnosed in over 2 million people, incidence rising at about 2.6% per year. In Hispanics, Loh et al showed a retrospective 5-year one-institution study that revealed an incidence of 3% for NMSC, in a population that is younger and mainly females as compared to Caucasian and Asians. In the past two decades, melanomas incidence among Hispanics has risen by 20%. Hispanics are younger at diagnosis, present with thicker tumors (>1mm, 35% to 25%), regional involvement (12 to 8%), and distant metastasis (7 to 4%), having the worst survival rate as compared to whites. In general, even though increasing, the incidence of NMSC and MM is lower in Hispanics than Caucasians, however, the mortality is higher. The later stage at diagnosis and worse prognosis in Hispanics have been attributed to several factors: 1.) Less awareness of risks or symptoms leading to a lack of linguistically or culturally targeted screening efforts.20 2.) Decline in sun-safe behaviors because of increasing acculturation.21, 22 3.) Less access to health insurance-- more than 15% Hispanics in last census lack medical coverage causing delays in seeking treatment.23 Many of these factors may be associated with lower socioeconomic status (SES). For cancer control efforts to succeed, we must better understand the major causes of advanced presentation of melanoma in Hispanics (Hispanics and Latinos) who represent the most rapidly expanding demographic segment in the U.S. Increased awareness of skin cancer and ways to prevent it on the part of providers and patients has the potential to decrease incidence, increase early diagnosis, and improve outcomes among Hispanics. Primary care physicians and dermatologists can dispel the myth that melanoma only affects NHWs and educate Hispanic patients in a culturally appropriate manner on melanoma risk factors, how to recognize sunburn, how to identify abnormal lesions, and the need to check non-sun-exposed areas for ALMs that are comparatively more common among Hispanics than among NHWs. J Drugs Dermatol. 2019;18(3 Suppl):s117-120.