Rurality, Race, and Lower Income: Researchers Find All Affect the Incidence of Skin Cancer

By: Celeste L. Dixon
Posted: Thursday, August 8, 2024

Considering race and locality as social determinants of health, researchers reporting in the Journal of Drugs in Dermatology found that rural people of color were more likely than both their urban counterparts and rural non-Hispanic White individuals to have a positive skin cancer history. However, income plays a role in risk as well, stated Scott A. Elman, MD, of the University of Miami Miller School of Medicine, and colleagues: When household income exceeded $100,000, they saw no significant difference in prevalence or odds of skin cancer between urban and rural settings.

The team’s cross-sectional study used Behavior Risk Factor Surveillance Survey data from 2018 to 2021. A total of 11% of 170,871 participants, across five U.S. states, reported a positive history of skin cancer. Across all races, rural populations had a higher prevalence of skin cancer history (P < .001).

Rural non-Hispanic Whites had greater odds of a skin cancer history than their urban counterparts (odds ratio [OR] = 1.40), the investigators noted. Compared with their urban counterparts, “the odds were approximately twice as high for rural Black (OR = 1.74), Hispanic (OR = 2.31), and Other Race, non-Hispanic (OR = 1.99) [individuals], and 20 times higher for Asian [individuals] (OR = 20.46).” However, no significant difference emerged for American Indian/Alaskan Native individuals (OR = 1.5).

“Multicomponent interventions that incorporate educational, environmental, and policy-based changes are effective in promoting protection [from ultraviolet rays] at a community level compared to educational interventions and health messaging alone,” declared Dr. Elman and colleagues. Making such changes is even more imperative considering that skin cancer mortality is greater in people of color, often because of late diagnosis, according to the investigators. Rural populations who are diagnosed with melanoma also have increased odds of metastatic disease.

Disclosure: The study authors reported no conflicts of interest.

Journal of Drugs in Dermatology