Dr. Aida Lugo-Somolinos
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More than three-quarters of Hispanic patients in North Carolina aren’t performing skin self-exams (SSE) to detect possible skin cancers, and physicians need to do a better job of educating their patients about this potentially life-saving practice, say researchers in the School of Medicine at the University of North Carolina at Chapel Hill.
Study results were reported earlier this year in the Research Letters section of the Archives of Dermatology.
“We know that the rates of melanoma, one of the deadliest skin cancers, are on the rise globally, and in the U.S., Hispanics and African-Americans often present to physicians with more advanced cases of the cancer,” said Dr. Aida Lugo-Somolinos, professor of dermatology at UNC. “We wanted to understand more fully why Hispanic patients weren’t performing SSEs and what role the physician was playing in the process, especially since SSEs may lead to earlier melanoma diagnosis.”
Researchers worked with Hispanic patients at Piedmont Health Services in Carrboro, UNC dermatology clinics and El Pueblo, a Hispanic advocacy group in Raleigh. Most participants, Lugo-Somolinos said, listed their country of origin as Mexico, but nine other countries were listed.
Among the results: 23 percent reported knowing skin-cancer risk factors, such as sun exposure; 9 percent received a regular skin examination; and 22 percent performed SSEs.
Darker-skinned individuals in the U.S., including Hispanics and African-Americans, have lower rates of skin cancer than Caucasians, but the risk remains, Lugo-Somolinos said. “We want to encourage primary care providers to help make their non-Caucasian patients aware they are also at risk for skin cancer, especially through sun exposure, even with darker skin,” she added.
Lugo-Somolinos, originally from Puerto Rico, came to UNC six years ago. She initially thought cultural traditions, especially the strong sense of modesty among women that she observed in her Puerto Rican patients, might explain her North Carolina Hispanic patients’ reluctance to perform SSEs or request skin exams from health care providers. She quickly learned that was not the case with the study population of Hispanics.
“We did not find patient modesty to be a barrier, but what we did find was that patients felt they didn’t have enough time with physicians to ask about preventive care such as skin exams,” she said. “We also learned that physicians were not taking the opportunity to raise the subject with their patients, as they do with other health promotion topics such as smoking cessation or seatbelt use.”
Lugo-Somolinos noted her varied experiences with patients in Puerto Rico and North Carolina highlight that there is no monolithic “Hispanic” community – and that individual countries and cultures must be understood and considered when working with Hispanic patients, she added.
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