Hispanic Americans are more apt to be diagnosed with skin cancer in its later stages, when it's more likely to be fatal. One reason is the misconception that people with darker skin are immune from skin cancer, researchers say. Another is that public health campaigns tend focus on lighter-skinned people, inadvertently reinforcing that belief.
"There is an idea among Hispanics that 'People like me don't get skin cancer,' " says Dr. Elliot J. Coups, a researcher and resident member at Rutgers Cancer Institute of New Jersey. "It's true that they're at lower risk, but they're still at some risk — it's not zero risk. Hispanic individuals can be diagnosed with skin cancer."
The lifetime risk for being diagnosed with melanoma, the deadliest form of skin cancer, is just 0.5 percent for Hispanics, compared to 2.4 percent in non-Hispanic whites and 0.1 percent in blacks, according to the American Cancer Society. But 26 percent of Hispanic patients with melanoma aren't diagnosed until the cancer has progressed to the late stages, compared to 16 percent of white patients. That vastly increases their risk of death.
It's not because people from Latin American countries don't realize they need to protect themselves from the sun, Coups says. Instead, his research has found the opposite – that as Hispanic people assimilate to mainstream U.S. culture, they're more likely put themselves at risk, with behaviors including lower use of sunscreen and sun-protective clothing.
Add that to the fact that the vast majority of public health campaigns link skin cancer risk to skin tone, and it's no wonder many Hispanics think they needn't worry, says Jennifer Hay, a behavioral scientist and clinical health psychologist who treats melanoma patients at the Memorial Sloan Kettering Cancer Center in New York City.
In 2014, Hay and her colleagues looked at skin cancer education practices in Albuquerque, N.M., where 40 percent of the city's population self-identifies as Hispanic. She found that U.S.-born Hispanics were more likely than non-Hispanic whites to report misconceptions like, "People with skin cancer would have pain or other symptoms prior to diagnosis."
They were less likely to have gotten skin-cancer screening from a physician and less likely to wear sun-protective clothing, but as likely to use sunscreen and seek shade as were non-Hispanic whites.
There needs to be an increase in culturally relevant skin cancer prevention campaigns that target ethnic minorities, Hays says. Her current research, conducted in Spanish Harlem in New York City, has found that people do want information on preventing skin cancer.
"What we found is that people are really receptive to this kind of information, but they have not had the kind of access to it that we would like to see," says Hay. "That behooves us as public health researchers to find vehicles and channels to get this information out to more populations who could benefit from it."
That's not to say that skin tone doesn't matter; lighter-skinned people still do face a greater risk. "Latinos have a wide range of skin types," says Hay. "That range of skin type is much more important than whether one self-identifies as Latino or Hispanic. You can self-identify as Latino and still have very light skin."
But Dr. Henry W. Lim, president of the American Academy of Dermatology and chairman of dermatology at Henry Ford Health System in Detroit, says everyone, no matter their skin tone, should practice sun safety. "We should go out and enjoy outdoor activities, but we should try to seek shade and we should wear appropriate clothing to cover up."
Ellie Hartleb is a freelance writer based in Washington, D.C.