Perez Maritza I.
J Drugs Dermatol. 2019 Mar 1;18(3):s117-120.
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.
在过去二十年里，西班牙裔人口一直是美国人口增长的主要驱动力。2016年，西班牙裔占美国人口的18%，是仅次于白人的第二大种族或族裔群体，使西班牙裔成为美国最大的少数族裔。非黑色素瘤皮肤癌（NMSC）是美国最常见的恶性肿瘤，超过350万人被诊断出患有该病，涉及200多万人，发病率每年约上升2.6%。在西班牙裔人群中，洛等人进行了一项为期5年的单机构回顾性研究，结果显示，与白人和亚洲人相比，该人群中NMSC的发病率为3%，且年龄较轻，主要为女性。在过去二十年里，西班牙裔人群中黑色素瘤的发病率上升了20%。西班牙裔患者确诊时年龄更小，肿瘤更厚（>1mm，从35%升至25%），有区域转移（从12%降至8%）和远处转移（从7%降至4%），与白人相比生存率最差。总体而言，尽管NMSC和MM的发病率在上升，但西班牙裔人群中的发病率低于白种人，然而死亡率更高。西班牙裔人群确诊时分期较晚且预后较差，这归因于几个因素：1. 对风险或症状的认识不足，导致缺乏针对语言或文化的筛查工作。2. 由于文化适应程度提高，防晒行为减少。3. 医疗保险覆盖率较低——在上次人口普查中，超过15%的西班牙裔没有医疗保险，导致就医延迟。许多这些因素可能与较低的社会经济地位（SES）有关。为使癌症控制工作取得成功，我们必须更好地了解西班牙裔（西班牙裔和拉丁裔）人群中黑色素瘤晚期发病的主要原因，他们是美国人口中增长最快的群体。提高医疗服务提供者和患者对皮肤癌及其预防方法的认识，有可能降低西班牙裔人群中的发病率，提高早期诊断率，并改善治疗效果。初级保健医生和皮肤科医生可以消除黑色素瘤只影响非西班牙裔白人的误解，并以适合文化背景的方式对西班牙裔患者进行黑色素瘤风险因素、如何识别晒伤、如何识别异常病变以及检查非暴露部位是否有非典型痣（在西班牙裔人群中比在非西班牙裔白人中相对更常见）等方面的教育。《皮肤药物学杂志》。2019年；18(3增刊):s117 - 120。
