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Donelian A, Liu Z, Trager MH, Momen-Heravi F, Samie FH. Racial and ethnic disparities in basal cell carcinoma treated by Mohs micrographic surgery: the Columbia experience. Arch Dermatol Res 2024; 316:151. [PMID: 38734798 DOI: 10.1007/s00403-024-02858-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/02/2024] [Accepted: 04/07/2024] [Indexed: 05/13/2024]
Affiliation(s)
- Alec Donelian
- College of Dental Medicine, Columbia University, New York, NY, USA
| | - Zheyan Liu
- Department of Biostatistics, Columbia University, New York, NY, USA
| | - Megan H Trager
- Department of Dermatology, Columbia University Irving Medical Center, Herbert Irving Pavilion, 12th Floor, New York, NY, 10032, USA
| | - Fatemeh Momen-Heravi
- College of Dental Medicine, Columbia University, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA
| | - Faramarz H Samie
- Department of Dermatology, Columbia University Irving Medical Center, Herbert Irving Pavilion, 12th Floor, New York, NY, 10032, USA.
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2
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Rivera Rivera JN, Lacson JCA, Kim Y, Roetzheim RG, Sutton SK, Soto-Torres B, Vadaparampil ST, Kanetsky PA. Sharing and seeking information about skin cancer risk and prevention among Hispanic people from Florida and Puerto Rico. PEC INNOVATION 2023; 3:100232. [PMID: 38028436 PMCID: PMC10679524 DOI: 10.1016/j.pecinn.2023.100232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/02/2023] [Accepted: 11/11/2023] [Indexed: 12/01/2023]
Abstract
Objective To explore factors associated with communication and information-seeking after receipt of skin cancer prevention information among Hispanic individuals. Methods Multivariable logistic regression was used to analyze existing data on demographics, personal experience, salience, and beliefs variables collected from Hispanic individuals to determine independent associations with sharing and seeking information about skin cancer prevention. Results Of 578 participants, 53% reported any communication about skin cancer prevention behaviors or skin cancer genetic risk; and 31% and 21% sought additional information about preventive behaviors or genetic risk, respectively. Female sex, greater perceived severity, higher comparative chance of getting skin cancer, and lower health literacy were associated with greater communication, while having no idea of one's own skin cancer risk was related to less communication. Greater health numeracy and higher cancer worry were associated with information-seeking about prevention behaviors and genetic risk. Conclusion Up to half of participants reported communication or information-seeking, although factors associated with specific activities differed. Future studies should evaluate how to promote communication behaviors in the Hispanic community and how sharing and seeking information influence an individual's network prevention practices. Innovation Several factors related to communication behaviors among Hispanic people after obtaining skin cancer prevention information were identified.Trial registration: This trial was registered on clinicaltrials.gov (NCT03509467).
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Affiliation(s)
- Jessica N. Rivera Rivera
- Department of Health and Behavioral Outcomes, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
- Health Care Delivery Research, MedStar Health Research Institute, Washington, DC, United States of America
| | - John Charles A. Lacson
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
| | - Youngchul Kim
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
| | - Richard G. Roetzheim
- Department of Family Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America
| | - Steven K. Sutton
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
| | - Brenda Soto-Torres
- Public Health Program, Ponce Health Sciences University, Ponce, PR, United States of America
| | - Susan T. Vadaparampil
- Department of Health and Behavioral Outcomes, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
| | - Peter A. Kanetsky
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
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3
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Camacho I, Biro M, Stevenson ML, Deng M. Characteristics of Hispanic patients with nonmelanoma skin cancer undergoing Mohs micrographic surgery: a review of the literature. Int J Dermatol 2023; 62:1317-1323. [PMID: 37737563 DOI: 10.1111/ijd.16855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/30/2023] [Accepted: 09/08/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Nonmelanoma skin cancer (NMSC) is the most common cancer worldwide and is frequently treated with Mohs micrographic surgery (MMS); however, data regarding characteristics of Hispanic patients undergoing MMS for NMSC are limited. OBJECTIVE To review the characteristics of Hispanic patients undergoing MMS for NMSC in the United States. METHODS A systematic review of PubMed articles from inception through September 2022 providing data for Hispanic patients undergoing MMS for NMSC was completed. RESULTS Overall, six publications met inclusion criteria and provided data for 2,856 Hispanic patients that underwent MMS for 2,955 NMSCs. Results demonstrate 60% of Hispanic patients were male, and the majority of NMSCs were basal cell carcinoma (BCC) (71%), followed by squamous cell carcinoma (SCC) (21%). Additionally, a larger percentage of pigmented BCC was found in the Hispanic population. While there is conflicting data in the literature, Hispanic patients may also have larger MMS defects when controlled for additional variables. Finally, over 64% of NMSCs in Hispanic patients were in high-risk locations. CONCLUSION Literature regarding the characteristics of Hispanic patients undergoing MMS for NMSC demonstrates most patients were male, BCC was the most common tumor subtype, and the majority of NMSCs were in high-risk locations.
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Affiliation(s)
- Isabella Camacho
- Department of Dermatology, MedStar Washington Hospital Center, Washington, DC, USA
- Department of Dermatology, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Mark Biro
- Department of Dermatology, MedStar Washington Hospital Center, Washington, DC, USA
- Department of Dermatology, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Mary L Stevenson
- The Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, NY, New York, USA
| | - Min Deng
- Department of Dermatology, MedStar Washington Hospital Center, Washington, DC, USA
- Department of Dermatology, MedStar Georgetown University Hospital, Washington, DC, USA
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Crowder SL, Buro AW, Lacson JCA, Del Rio J, Kim Y, Roetzheim RG, Sutton SK, Vadaparampil ST, Soto-Torres B, Stern M, Kanetsky PA. Qualitative assessment of uptake retention and evaluation of prevention materials for skin cancer among Hispanics. PATIENT EDUCATION AND COUNSELING 2023; 112:107742. [PMID: 37028174 PMCID: PMC10164708 DOI: 10.1016/j.pec.2023.107742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVE Examine retention and evaluation of incorporating melanocortin-1 receptor genetic risk information materials in a skin cancer prevention intervention conducted in Hispanics living near Tampa, Florida and Ponce, Puerto Rico. METHODS Two researchers applied thematic content analysis to identify major themes of open-ended responses (n = 1689) from 489 participants. RESULTS Five major thematic categories emerged: 1) intervention comments; 2) tips and tricks; 3) cancer prevention; 4) general information; and 5) risk factors and genetics. Responses captured under intervention comments (e.g., information was clear, easy to understand) and tips and tricks for sun protection (e.g., using sunscreen, wearing protective clothing) were most frequent. Participants noted the importance of conducting skin exams professionally or at home. English-preferring Tampa residents stated their individual risk factors, especially race and/or ethnicity, more frequently than Ponce residents and Spanish-preferring Tampa residents. Ponce residents were more likely to comment on wanting to share intervention materials with family and friends. CONCLUSION Findings suggest Hispanic participants implemented sun safety activities.
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Affiliation(s)
- Sylvia L Crowder
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA
| | - Acadia W Buro
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA
| | - John Charles A Lacson
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA
| | - Jocelyn Del Rio
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA
| | - Youngchul Kim
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Richard G Roetzheim
- Department of Family Medicine, Morsani College of Medicine, University of South Florida, Tampa, USA
| | - Steven K Sutton
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Susan T Vadaparampil
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA
| | | | - Marilyn Stern
- Department of Child and Family Studies, University of South Florida, Tampa, USA
| | - Peter A Kanetsky
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA.
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Beltrami EJ, Kodumudi V, Gronbeck C, Feng H. Poor treatment outcomes of keratinocytic carcinoma and barriers to Mohs micrographic surgery highlights the need to address access and coverage among Medicaid beneficiaries. J Am Acad Dermatol 2023; 89:168-169. [PMID: 36863579 DOI: 10.1016/j.jaad.2023.02.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/04/2023] [Accepted: 02/09/2023] [Indexed: 03/04/2023]
Affiliation(s)
- Eric J Beltrami
- University of Connecticut School of Medicine, Farmington, Connecticut
| | - Vijay Kodumudi
- University of Connecticut School of Medicine, Farmington, Connecticut
| | - Christian Gronbeck
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut
| | - Hao Feng
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut.
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Abstract
Skin cancer is often associated with greater morbidity and mortality in skin of color patients because most medical literature and research on skin cancer to date has been predominantly focused on lighter skin types. It is crucial that dermatologic providers be able to recognize different presentations of skin cancer in skin of color patients to optimize the early detection of these tumors and ensure equitable outcomes. This article details the epidemiology, risk factors, clinical features, and disparities in the treatment of melanoma, squamous cell carcinoma, basal cell carcinoma, and mycosis fungoides subtype of cutaneous T-cell lymphoma in skin of color patients.
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Affiliation(s)
- Ananya Munjal
- University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Nkanyezi Ferguson
- University of Missouri Department of Dermatology, Missouri, Columbia, MO, USA.
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Carrasquillo OY, Lambert J, Merritt BG. Comment on "Disparities in nonmelanoma skin cancer in Hispanic/Latino patients based on Mohs micrographic surgery defect size: A multicenter retrospective study". J Am Acad Dermatol 2022; 87:e129-e130. [PMID: 35671885 DOI: 10.1016/j.jaad.2022.04.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Osward Y Carrasquillo
- University of North Carolina School of Medicine, Department of Dermatology, Chapel Hill, North Carolina.
| | - Jeffrey Lambert
- University of North Carolina School of Medicine, Department of Dermatology, Chapel Hill, North Carolina
| | - Bradley G Merritt
- University of North Carolina School of Medicine, Department of Dermatology, Chapel Hill, North Carolina
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Clarke EL, Willenbrink TJ, Shelton M, Naeem A, Custer J, Lundgren AD, Boothe WD, Rathouz PJ, Adamson AS, Fox MC, Jambusaria-Pahlajani A. Association of Tumor Characteristics With Insurance Type Among Patients Undergoing Mohs Micrographic Surgery for Nonmelanoma Skin Cancer. JAMA Dermatol 2022; 158:919-922. [PMID: 35648411 DOI: 10.1001/jamadermatol.2022.1802] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Little is known about the association between insurance type and tumor or treatment characteristics among patients undergoing Mohs micrographic surgery (MMS) for nonmelanoma skin cancer (NMSC). Objective To investigate whether there are differences in tumor and treatment characteristics among patients undergoing MMS for NMSC by insurance type. Design, Setting, and Participants This retrospective cohort study included patients with NMSC who presented for surgery at an academic MMS practice between May 2017 and May 2019. Main Outcomes and Measures Preoperative and postoperative tumor diameters, number of MMS stages, type of closure, and number of high-risk tumors were compared based on insurance type among uninsured and underinsured patients and those with private insurance, Medicare, and Veterans Affairs (VA) insurance. Results A total of 1397 patients with NMSC (978 [70%] male; mean [SD] age, 68.5 [12.4] years) underwent 1916 MMS procedures. Of these patients, 868 (45%) had Medicare, 570 (30%) had private insurance, 299 (16%) had VA insurance, and 179 (9%) were treated at a safety net clinic or were uninsured. Compared with patients with private insurance, uninsured and underinsured patients had significantly larger preoperative tumor bed diameters (difference, 28%; 95% CI, 14%-43%; P < .001) and postoperative defect sizes (difference, 28%, 95% CI, 16%-41%; P < .001). Patients with Medicare and VA insurance did not have significantly different preoperative tumor bed diameters compared with patients with private insurance. Patients with VA insurance had larger postoperative defect sizes than patients with private insurance (difference, 12%; 95% CI, 2%-23%; P = .02). The number of MMS stages and type of closure did not significantly differ based on insurance type. Conclusions and Relevance In this cohort study of patients undergoing MMS for NMSC, larger preoperative tumor and postoperative defect sizes were associated with being uninsured or underinsured compared with privately insured. Future studies are required to determine why these differences exist to deliver optimal care to all patients.
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Affiliation(s)
- Emily L Clarke
- Division of Dermatology, Department of Internal Medicine, Dell Medical School at The University of Texas at Austin
| | | | - Megan Shelton
- University of Michigan School of Medicine, Department of Dermatology, Ann Arbor
| | - Aneeqah Naeem
- Division of Dermatology, Department of Internal Medicine, Dell Medical School at The University of Texas at Austin.,The Warren Alpert Medical School at Brown University, Providence, Rhode Island
| | - James Custer
- Department of Population Health, Dell Medical School at The University of Texas at Austin
| | | | - William D Boothe
- Texas Tech Health Sciences Center, Department of Dermatology, Lubbock
| | - Paul J Rathouz
- Department of Population Health, Dell Medical School at The University of Texas at Austin
| | - Adewole S Adamson
- Division of Dermatology, Department of Internal Medicine, Dell Medical School at The University of Texas at Austin
| | - Matthew C Fox
- Division of Dermatology, Department of Internal Medicine, Dell Medical School at The University of Texas at Austin
| | - Anokhi Jambusaria-Pahlajani
- Division of Dermatology, Department of Internal Medicine, Dell Medical School at The University of Texas at Austin
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Sacksner JP, Kaundinya T, Daftary K, Jackson KL, Kundu RV. Skin tone preferences and their influence on skin care behaviors. Arch Dermatol Res 2022; 314:961-966. [PMID: 34985574 DOI: 10.1007/s00403-021-02320-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/15/2021] [Accepted: 12/22/2021] [Indexed: 11/02/2022]
Abstract
Knowledge regarding skin tone preferences and their influence on skincare behaviors among people of color is limited. The objective of this study was to determine whether there is a difference between ideal and actual skin tone among people of color and whether this difference is associated with tanning and sunscreen use. This was a one-time, voluntary, anonymous, electronic survey designed in REDCap and delivered through ResearchMatch, a national electronic, recruitment tool. Eligible participants were at least 18 years old and self-identified as Black, Asian, Latinx, American Indian/Alaskan Native or Mixed Race. In total, 548 completed survey results were analyzed using SAS. Only the Latinx population was found to have a significant preference for tanner skin (p < 0.05). The Latinx population had significantly more subjects that participated in outdoor tanning than both the Black (p < 0.0001) and Asian population (p < 0.05). Latinx participants who indicated a preference for tanner skin were 2.8 times more likely to never use sunscreen than those without this preference (OR = 2.821, CI = 1.029-7.732, p < 0.05). Our findings have implications for how dermatologists screen, treat, and educate Latinx and skin of color populations.
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Affiliation(s)
- Jamie P Sacksner
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 North St. Clair, Suite 1600, Chicago, IL, 60611, USA
| | - Trisha Kaundinya
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 North St. Clair, Suite 1600, Chicago, IL, 60611, USA. .,Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.
| | - Karishma Daftary
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 North St. Clair, Suite 1600, Chicago, IL, 60611, USA
| | - Kathryn L Jackson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Roopal V Kundu
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 North St. Clair, Suite 1600, Chicago, IL, 60611, USA
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