Skin Cancer Disparities Persist in Latine/Hispanic Population

Despite making up the second largest ethnic group in the US, Latine and Hispanic individuals face alarming disparities in skin cancer outcomes, according to a review published in Cutis in collaboration with the Skin of Color Society.1

The review showed that while their lifetime risk of developing skin cancer is lower than that of non-Hispanic White individuals, Latine patients are more likely to receive a diagnosis at a more advanced stage and experience higher rates of morbidity and mortality. According to the authors, factors contributing to these ethnic disparities include delays in diagnosis, limited awareness about skin cancer risks, and inequities in access to care.

Many patients of color are unaware of the risk for melanoma on acral sites like palms of hands and soles of feet. | Image credit: anna.stasiia – stock.adobe.com

The unique clinical features of skin cancer in Latine patients often complicate early detection. For instance, melanoma in Latine individuals commonly manifests on the torso, lower extremities, and less visible areas like the soles of the feet or under nails, making it easier to overlook. Other research looking at melanoma knowledge among patients of color has shown that many are unaware of the risk for melanoma on acral sites like palms and soles, highlighting the need for more inclusive education.2

“Improving cultural misconceptions regarding skin conditions, especially skin cancer, is another important consideration in the Latine/Hispanic community,” the authors added.1,3 “Many Latine/Hispanic individuals wrongly believe they cannot develop skin cancer due to their darker skin tones and lack of family history.”

Insurance coverage disparities are another major contributor to poor skin cancer outcomes for Latine and Hispanic patients.1 Nearly 1 in 5 Latine individuals in the US lack health insurance, compared with only 8% of non-Hispanic White individuals, limiting their access to preventive screenings and timely treatments. Latine employees are also less likely to receive employer-sponsored health care coverage than their White counterparts (27% vs 53%). Even among those with insurance, high out-of-pocket costs and fear of financial strain discourage some from seeking care.

“Other factors that may impact skin cancer outcomes in this population include (but are not limited to) lack of or inadequate health insurance, medical mistrust, linguistic barriers and/or individual/cultural perspectives, along with limited research,” the authors added. “Recognizing and addressing these (albeit complex) barriers that contribute to the inequitable access to health care in this population remains a critical step toward improving skin cancer outcomes.”

Medical mistrust among Latine/Hispanic patients is often rooted in experiences of discrimination within health care settings and significantly impacts treatment adherence and health outcomes. A survey included in the review showed strong links between mistrust and perceived discrimination based on race, language, income, and insurance status. Even after adjusting for race and language, income-based discrimination persisted, and patients relying on public insurance like Medicare reported higher levels of mistrust compared with those holding private insurance.

“Together, these findings support the notion that individuals who have low socioeconomic status and lack insurance coverage—disproportionately historically marginalized populations—are more likely to perceive discrimination in health care settings, have greater medical mistrust, and experience poorer health outcomes.”

With the Latine community projected to grow to over 25% of the US population by 2060, addressing these disparities is a public health imperative.

References

1. Valencia J, Ramirez F, Dubocq-Ortiz C, Vasquez R. Disparities in skin cancer outcomes in the Latine/Hispanic population. Cutis. 2024;114(5):146-152. doi:10.12788/cutis.1129
2. Robinson JK, Joshi KM, Ortiz S, Kundu RV. Melanoma knowledge, perception, and awareness in ethnic minorities in Chicago: recommendations regarding education. Psychooncology. 2011;20(3):313-320. doi:10.1002/pon.1736
3. Lukowiak TM, Aizman L, Perz A, et al. Association of Age, Sex, Race, and Geographic Region With Variation of the Ratio of Basal Cell to Cutaneous Squamous Cell Carcinomas in the United States. JAMA Dermatol. 2020;156(11):1192-1198. doi:10.1001/jamadermatol.2020.2571