Disparities in knowledge about skin cancer diagnoses in US adults

In 2007-2008, nearly 20% of American adults previously diagnosed with skin cancer were unable to recall the type of skin cancer they had been diagnosed with. In the last decade, numerous programs have been launched to improve skin cancer education in the United States (U.S.). The purpose of this study is to re-evaluate the current proportion of U.S. adults who are unable to identify the type(s) of skin cancer they have had despite these educational efforts. This cross-sectional survey study included 4,158 U.S. adults participating in the 2019-2021 National Health Interview Surveys who reported a skin cancer diagnosis of melanoma, non-melanoma skin cancer, and/or skin cancer of unknown type. Logistic regression models were used to evaluate factors associated with decreased dermatologic health literacy. Overall, 15.8% (n = 657) of participants did not know what type of skin cancer they had been diagnosed with. Participants were less likely to know their skin cancer diagnosis if they were male [Odds Ratio (OR) 0.802, 95% CI 0.682-0.952], Hispanic (OR 1.96, 95% CI 1.10-3.50), less educated (ORs from 1.42 to 2.60, 95% CIs from 1.16 to 3.70), had lower family incomes (ORs from 1.37 to 1.99, 95% CIs from 1.01 to 2.60), or resided in a nonmetropolitan area (OR 1.35, 95% CI 1.040-1.761). Participants with lower self-reported health status (ORs from 1.59 to 1.79, 95% CIs from 1.25 to 1.89) and public health insurance policies such as Medicaid (OR 2.43, 95% CI 1.48-4.00) also were less likely to know their skin cancer diagnosis. These results demonstrate that the overall percentage of U.S. adults who are not knowledgeable about their skin cancer diagnosis has decreased. However, disparities in skin cancer health literacy persist in many socioeconomically disadvantaged groups. Dermatologists and public health authorities should consider targeted skin cancer education programs to address disparities in these groups.