Improving the Dermatologic Care of Individuals with Autism: A Review of Relevant Issues and a Perspective

Skin Cancer Diagnosis Among People With Disabilities

INTRODUCTION

People with disabilities face unique challenges that may affect skin cancer prevention, diagnosis, and access to treatment. These challenges could be exacerbated by the COVID-19 pandemic. In 2022, the prevalence of self-reported skin cancer diagnoses, delayed medical care because of the coronavirus disease 2019 (COVID-19) pandemic, and skin cancer risk factors among people with disabilities were estimated.

METHODS

Data from the 2020 National Health Interview Survey (N=31,568 U.S. adults) were analyzed. Skin cancer diagnosis, age at the time of skin cancer diagnosis, skin cancer risk factors (e.g., sun protection), and delayed medical care because of the COVID-19 pandemic were included. Disability status was measured using the Washington Group Short Set on Functioning, which includes vision, hearing, mobility, communication, self-care, and cognitive disabilities.

RESULTS

Although 8.8% of U.S. adults reported having a disability, people with disabilities accounted for 14.7% of all self-reported skin cancer diagnoses, including 17.5% of melanoma diagnoses. Notably, people with disabilities were on average, older (mean age=59.8 years) than people without disabilities (mean age=46.8 years). Models that adjusted for age and other demographics revealed that people with disabilities had higher odds of delaying medical care because of the COVID-19 pandemic (OR=1.65, 95% CI=1.41, 1.94); people with disabilities reported being diagnosed with skin cancer later in life (age 61.5 vs 54.0 years; p<0.001) but had odds of reporting any skin cancer (OR=1.11, 95% CI=0.93, 1.32) or melanoma diagnosis (OR=1.33, 95% CI=0.95, 1.87) similar to those of people without disabilities.

CONCLUSIONS

Because of disability-related challenges, older age, and delaying medical care during the pandemic, people with disabilities may be at increased risk for inequitable skin cancer outcomes.

Barriers to healthcare access in pediatric dermatology: A systematic review

Barriers to healthcare access are healthcare inequities that have been widely studied across different medical specialties. No studies have previously evaluated the state of barriers to healthcare access research in pediatric dermatology. A systematic review was conducted to examine the types of barriers identified within pediatric dermatology literature. Relevant information was extracted and categorized into the themes of systemic, sociocultural, or individual barriers. The systemic barriers we found include finances, wait times, and geography. The sociocultural barriers included culture beliefs and communication. Patient beliefs and health knowledge were found as individual barriers. The small number and limited scope of studies we identified suggest that barriers to healthcare access in pediatric dermatology remain an understudied topic. Additional research is needed to further characterize these barriers to dermatologic care, as well as the impact of any interventions designed to overcome them.