Purpose: Skin cancer is a major health concern in the general population, but there are conflicting findings regarding its relationship to where people live. The purpose of this study was to determine whether skin cancer differs by metropolitan status in the general population of U.S. adult males and females aged 18 and older.
Methods: This cross sectional analysis used 2015 data from the Behavioral Risk Factor Surveillance System (BRFSS) for males and females aged 18 years and older. Multiple logistic regression analysis was used to assess the relationship between skin cancer and metropolitan status separately by gender while controlling for other cancers, general health, educational level, employment status, income level, ethnicity, and age.
Results: Across states, 20% of males and 15% of females reported skin cancer and roughly 20% of both males and females lived in rural areas, 40% in suburban areas, and 40% in urban areas. After controlling for health, socioeconomic and demographic factors, skin cancer and metropolitan status were significantly related for both males and females. Skin cancer was also related to other cancers, income level, ethnicity/race, and age for both genders.
Conclusion: This study found that skin cancer significantly differed by metropolitan status with both males and females living in suburban areas reporting more cancer than those living in urban or rural areas. Limitations to this study include a broad definition of skin cancer and no lifestyle variables specific to sun exposure. It is recommended that general practitioners screen, educate, and provide referral services as necessary for both males and females, especially those who live in suburban areas, have a history of cancer, are 65 or older, and are white, non-Hispanic.
Hannah J Bram, Megan Frauendorfer, Shawna Spencer and Jessica L Hartos
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