Assessing skin cancer knowledge, attitudes, and practices in an underserved population at a student-run free clinic

Background: Skin cancer is one of the most common malignancies worldwide with a rising incidence rate. Early detection and preventative practices are essential to reduce morbidity and mortality. Underserved populations in particular face additional challenges to dermatologic care, which may contribute to reduced skin cancer awareness and preventative practices. Limited research has explored the knowledge, attitudes, and practices regarding skin cancer among patients at a Student-run free clinic (SRFC). This study aimed to assess the knowledge, attitude, and practices regarding skin cancer at a SRFC.

Methods: An anonymous 31-question validated survey was distributed on paper to individuals ages 18+ attending a SRFC. The survey collected data on demographics, knowledge, attitudes, and practices regarding sun exposure and skin cancer. Descriptive statistics were used to analyse trends in overall dermatologic knowledge and sun exposure practices, and to determine if there were significant differences in outcome scores across demographic characteristics. Analyses were performed using Student’s t-tests and with Analysis of Variance (ANOVA) tests. Tukey’s post-hoc adjustment was used when looking at pairwise comparisons for significant ANOVA results.

Results: Among 56 participants, participants were more likely to be older (54.6% were 51+ years), male (53.6%), either Black (35.7%) or Hispanic (32.1%), and were generally more highly educated (52.7% with tertiary education ). Sunscreen use was low, with 41.1% reporting sunscreen use, and only 17.9% reapplying sunscreen. Only 5% of participants reported that they have had their skin annually examined by a dermatologist. Fitzpatrick I-IV skin type group had significantly higher knowledge scores than the Fitzpatrick V-VI skin type group (5.4 vs. 4.3; p=.0175). Additionally, Black participants had significantly lower preventative practice scores than Hispanic participants (1.7 vs. 3.5; adjusted p =.0187).

Conclusion: Participants demonstrated variable knowledge and prevention practices, with gaps in sunscreen use and recognition of skin cancer warning signs. By identifying disparities in underserved populations, these findings highlight areas for targeted educational interventions and improving access to dermatologic care. Future work aimed at addressing such gaps in the knowledge, attitudes, and practices regarding skin cancer risk factors, screening, and prevention may serve to reduce skin cancer burden in vulnerable populations