Objectives: Florida has the second highest incidence of melanoma in the United States, and more than 600 Floridians die from melanoma annually. Given the lack of population-based data on skin cancer screening among the different US geographic regions, we compared skin cancer screening rates among Floridians to those in the rest of the South, the Northeast, the Midwest, and the West.
Methods: We used data from the 2000 and 2005 National Health Interview Survey. Data were grouped according to whether participants reported ever receiving a skin cancer examination in their lifetime. Data were pooled, and analyses accounted for sample weights and design effects. Multivariable logistic regression analyses were performed with self-reported skin screening as the outcome of interest.
Results: Results showed that compared to the rest of the US, Floridians who were women 70 years old and older, reported being of “other” race, of non-Hispanic ethnicity, having a high school education, having health insurance, and employed in the service industry or unemployed, had significantly higher lifetime skin cancer screening rates than their subgroup counterparts residing in the other regions. Multivariable logistic regression showed that Floridians remained significantly more likely to have ever been screened for skin cancer compared to the other US regions after controlling for a variety of sociodemographic variables.
Conclusions: Increasing melanoma detection remains a national cancer goal for the US, and future identification of underlying causal factors for higher screening rates in Florida could inform intervention strategies in the other US regions.
2. National Cancer Institute and Centers for Disease Control and Prevention. State cancer profiles. U.S. state-level, U.S. historical state-level mortality by age, U.S. county-level, and Florida county-level mortality data queries. Mortality data based on the National Vital Statistics System public use data file. http://statecancerprofiles.cancer.gov
. Accessed December 5, 2011.
3. Watson M, Johnson CJ, Chen VW, et al. Melanoma surveillance in the United States: overview of methods. J Am Acad Dermatol 2011; 65 (5 suppl 1): S6–S16.
4. Weir HK, Marrett LD, Cokkinides V, et al. Melanoma in adolescents and young adults (ages 15–39 years): United States, 1999–2006. J Am Acad Dermatol 2011; 65 (5 suppl 1): S38–S49.
5. Singh SD, Ajani UA, Johnson CJ, et al. Association of cutaneous melanoma incidence with area-based socioeconomic indicators-United States, 2004–2006. J Am Acad Dermatol 2011; 65 (5 suppl 1): S58–S68.
6. Saraiya M, Hall HI, Thompson T, et al. Skin cancer screening among U.S. adults from 1992, 1998, and 2000 National Health Interview Surveys. Prev Med 2004; 39: 308–314.
7. LeBlanc WG, Vidal L, Kirsner RS, et al. Reported skin cancer screening of US adult workers. J Am Acad Dermatol 2008; 59: 55–63.
8. Berwick M, Begg CB, Fine JA, et al. Screening for cutaneous melanoma by skin self-examination. J Natl Cancer Inst 1996; 88: 17–23.
9. Goldberg MS, Doucette JT, Lim HW, et al. Risk factors for presumptive melanoma in skin cancer screening: American Academy of Dermatology National Melanoma/Skin Cancer Screening Program experience 2001–2005. J Am Acad Dermatol 2007; 57: 60–66.
10. Fernandez CA, McClure LA, LeBlanc WG, et al. A comparison of Florida skin cancer screening rates to the rest of the United States. Arch Dermatol 2012; 148: 393–395.
12. Environmental Protection Agency. How UV index is calculated. http://http://www.epa.gov
/sunwise/uvindex.html. Accessed January 12, 2012.
15. Lakhani NA, Shaw KM, Thompson T, et al. Prevalence and predictors of total-body skin examination among US adults: 2005 National Health Interview Survey. J Am Acad Dermatol 2011; 65: 645–648.
16. Ries LAG, Hankey BF, Miller BA, et al. SEER Cancer Statistics Review. Bethesda, MD: National Cancer Institute, 1998, 1973–1995.
20. Van Durme DJ, Ullman R, Campbell RJ, et al. Effects of physician supply on melanoma incidence and mortality in Florida. South Med J 2003; 96: 656–660.
21. Eide MJ, Weinstock MA, Clark MA. The association of physician-specialty density and melanoma prognosis in the United States, 1988 to 1993. J Am Acad Dermatol 2009; 60: 51–58.
22. Aneja S, Bordeaux JS. Association of increased dermatologist density with lower melanoma mortality. Arch Dermatol 2012; 148: 174–178.
23. Hernandez C, Mermelstein RJ. A conceptual framework for advancing melanoma health disparities research. Arch Dermatol 2009; 145: 1442–1446.
24. Wolff T, Tai E, Miller T. Screening for skin cancer: an update of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2009; 150: 194–198.
25. Katalinic A, Waldmann A, Weinstock MA, et al. Does skin cancer screening save lives?: an observational study comparing trends in melanoma mortality in regions with and without screening. Cancer April 19, 2012 [Epub ahead of print].
26. Waldmann A, Nolte S, Weinstock MA, et al. Skin cancer screening participation and impact on melanoma incidence in Germany—an observational study on incidence trends in regions with and without population-based screening. Br J Cancer 2012; 106: 970–974.
28. Goldsmith LA, Koh HK, Bewerse BA, et al. Full proceedings from the National Conference to Develop a National Skin Cancer Agenda. American Academy of Dermatology and Centers for Disease Control and Prevention, Washington, D.C., April 8–10, 1995. J Am Acad Dermatol 1996; 35 (5 Pt1): 748–756.
29. Aitken JF, Youl PH, Janda M, et al. Validity of self-reported skin screening histories. Am J Epidemiol 2004; 159: 1098–1105.