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PREVENTATIVE
MEDICINE

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ported patient embarrassment as the major barrier. As such, patients JAMA. 2016;316(4):429–435. doi:10.1001/jama.2016.8465
arriving at their physician’s office without a specific skin concern may not 6. Glazer, AM, Rigel, DS, Winkelmann, RR, Farberg, AS. Clinical
receive a full skin examination or appropriate skin care education. Diagnosis of SkinCancer Dermatologic Clinics , 2017-10-01, Vol-
Other factors to be considered regarding skin cancer prevention are ume 35, Issue 4, Pages 409-416, Guidelines of care for the manage-
behavioral − employees in the construction and agricultural industry ment of basal cell carcinoma
are at increased risk due to occupational hazard and UV exposure, and 7. Bichakjian, ChristopherKim, John Y.S. et al., Journal of the Amer-
as a result, preventive measures in these populations are paramount. ican Academy of Dermatology, Volume 78, Issue 3, 540 - 559
However, a recent survey found that more than half of agricultural 8. Schneider, SL, Lim, HW. Review of environmental effects of oxy-
workers in the United States reported never using sunscreen while out- benzone and other sunscreen active ingredients, Journal of the
side on a sunny day. While the use of at least one type of recommended American Academy of Dermatology, Volume 80, Issue 1,2019,
protective clothing was significantly higher in agricultural workers, the Pages 266-271, ISSN 0190-9622, https://doi.org/10.1016/
regular use of pants was almost twice their use of wide-brimmed hats, j.jaad.2018.06.033.
leading to prolonged direct sunlight exposure of high-risk areas such 9. Schneider, SL, Lim, HW. A review of inorganic UV filters zinc
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as the face and neck. oxide and titanium dioxide. Photodermatol Photoimmunol Pho-
This further elucidates the challenges in skin cancer prevention, es- tomed. 2019; 35: 442– 446. https://doi-org.uiwtx.idm.oclc.org
pecially for rural and migrant worker communities. According to data /10.1111/phpp.12439
from the National Center for Farmworker Health, there are over three 10. Oliveria SA, Heneghan MK, Cushman LF, Ughetta EA, Halpern
million migrant workers in the United States, with 83% identifying as AC. Skin Cancer Screening by Dermatologists, Family Practition-
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Hispanic, and 77% feeling most comfortable conversing in Spanish. ers, and Internists: Barriers and Facilitating Factors. Arch Dermatol.
Barriers to health care and access for these patients, such as scarcity of 2011;147(1):39–44. doi:10.1001/archdermatol.2010.414
Migrant Health Centers, lack of education, language barriers and cost 11. Ragan, KR, Buchanan, LN, Thomas, CC, Tai EW, Sussell A, Hol-
of medical care pose a significant challenge to agricultural workers. To man DM. Skin Cancer Prevention Behaviors Among Agricultural
this end, the focus on improving skin cancer prevention is vital, espe- and Construction Workers in the United States, 2015. Prev
cially in vulnerable populations. For migrant workers, the AAD has Chronic Dis 2019;16:180446. DOI: http://dx.doi.org/
implemented the Latino Outreach Program to provide skin cancer ed- 10.5888/pcd16.180446
ucation and screenings to migrant workers in California, Texas and 12. National Center for Farmworker Health. 2017 Agricultural Worker
Arizona. These types of initiatives could be especially beneficial in Population Estimates [Private Data Source].; 2020.
South Texas, where regular screening may be more difficult to access http://www.ncfh.org/population-estimates.html
outside of large urban settings. In the future, it is our hope that UIW-
SOM and UTHSCA can organize systematic skin cancer screening Fatima Raza, OMS-III is a third-year medical student at the
clinics, not just in San Antonio, but in its suburbs with lesser access to UIW School of Osteopathic Medicine. She is planning to apply
preventive screening and education. to Internal Medicine residency this year, and takes particular
interest in hematology/oncology, cardiology and health disparities in
References South Texas.
1. Stern RS. Prevalence of a history of skin cancer in 2007: results of
an incidence-based model. Arch Dermatol. 2010 Mar;146(3):279- Faraz Yousefian, DO is an intern at the Texas Institute for
82. doi: 10.1001/archdermatol.2010.4. PMID: 20231498. Graduate Medical Education and Research (TIGMER) in San
2. Siegel, RL, Miller, KD, Fuchs, HE, Jemal, A. Cancer statistics, Antonio, Texas. He is very passionate about mentoring nascent
2022. CA Cancer J Clin. 2022. https://doi.org/10.3322/ physicians and educating the general population about skin diseases and
caac.21708 the steps they can take to prevent them. Dr. Yousefian is a member of Bexar
3. Gloster HM Jr, Neal K. Skin cancer in skin of color. J Am Acad County Medical Society.
Dermatol. 2006 Nov;55(5):741-60; quiz 761-4. doi:
10.1016/j.jaad.2005.08.063. PMID: 17052479. Daniel Fischer, DO is a PGY-2 Dermatology resident at St.
4. Brandt, MG, Moore, CC. Non Melanoma Skin Cancer Facial Plas- John’s Episcopal Hospital in Far Rockaway, New York. He has
tic Surgery Clinics of North America, 2019-02-01, Volume 27, conducted close to 30 clinical trials and contributed to over one
Issue 1, Pages 1-13 dozen publications in the field of both clinical and cosmetic dermatology.
5. US Preventive Services Task Force. Screening for Skin Cancer: US He enjoys teaching and mentoring students and residents and plans to
Preventive Services Task Force Recommendation Statement. continue to do so beyond residency.

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