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The Impact of Acculturation on Skin Cancer Risk and Protective Behaviors in Hispanic Populations

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Abstract

The US Hispanic population faces rising skin cancer risks and poorer clinical outcomes, despite lower incidence rates. Acculturation, adopting elements of the dominant culture, may influence skin cancer attitudes and behaviors among Hispanics. We systematically reviewed PubMed articles from 2000 to 2023. Peer-reviewed English articles that assessed the relationship between acculturation and skin cancer in the Hispanic population were included. Andreeva et al. observed that lower acculturation levels correlated with increased use of shade and protective clothing (P < 0.05). More acculturated Latinos were more likely to use sunscreen, but this association weakened after adjusting for covariates (P > 0.48). Heckman et al. highlighted significant differences in skin cancer concern among Hispanic youth, with less acculturated individuals expressing greater worry (P < 0.05). Coups et al. found that higher acculturation was linked to less sun protective clothing usage and more frequent sunburns. Their subsequent online survey indicated that English-acculturated Hispanics engaged less in protective behaviors. Viola et al. reported that English-acculturated Hispanics perceived greater suntan benefits and had lower perceptions of skin cancer risk, severity, and concerns about photo-aging, along with higher melanoma risk factors, compared to Spanish-acculturated Hispanics. Acculturation influences skin cancer attitudes and behaviors in Hispanics. Tailored interventions based on acculturation levels are essential to reduce skin cancer risk. For example, educating English-acculturated Hispanics about skin cancer risks and prioritizing knowledge dissemination for Spanish-acculturated individuals may be effective approaches. These findings emphasize the need for targeted skin cancer prevention efforts to address disparities among US Hispanics.

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References

  1. Bureau UC. 2020 Census illuminates racial and ethnic composition of the country. Census.gov. Accessed October 4, 2023. https://www.census.gov/library/stories/2021/08/improved-race-ethnicity-measures-reveal-united-states-population-much-more-multiracial.html

  2. Bureau UC. Hispanic population to reach 111 million by 2060. Census.gov. Accessed October 4, 2023. https://www.census.gov/library/visualizations/2018/comm/hispanic-projected-pop.html

  3. SEER*explorer application. Accessed October 4, 2023. https://seer.cancer.gov/statistics-network/explorer/application.html?site=53&data_type=1&graph_type=2&compareBy=sex&chk_sex_3=3&chk_sex_2=2&rate_type=2&race=6&age_range=1&stage=101&advopt_precision=1&advopt_show_ci=on&advopt_show_count=on&hdn_view=1&advopt_show_apc=on&advopt_display=1#resultsRegion1

  4. Cormier JN, Xing Y, Ding M et al (2006) Ethnic differences among patients with cutaneous melanoma. Arch Intern Med 166(17):1907–1914. https://doi.org/10.1001/archinte.166.17.1907

    Article  PubMed  Google Scholar 

  5. Katalinic A, Waldmann A, Weinstock MA et al (2012) Does skin cancer screening save lives?: an observational study comparing trends in melanoma mortality in regions with and without screening. Cancer 118(21):5395–5402. https://doi.org/10.1002/cncr.27566

    Article  PubMed  Google Scholar 

  6. Hu S, Parmet Y, Allen G et al (2009) Disparity in melanoma: a trend analysis of melanoma incidence and stage at diagnosis among whites, Hispanics, and blacks in Florida. Arch Dermatol 145(12):1369–1374. https://doi.org/10.1001/archdermatol.2009.302

    Article  PubMed  Google Scholar 

  7. Pollitt RA, Swetter SM, Johnson TM, Patil P, Geller AC (2012) Examining the pathways linking lower socioeconomic status and advanced melanoma. Cancer 118(16):4004–4013. https://doi.org/10.1002/cncr.26706

    Article  PubMed  Google Scholar 

  8. Ortiz CAR, Goodwin JS, Freeman JL (2005) The effect of socioeconomic factors on incidence, stage at diagnosis and survival of cutaneous melanoma. Med Sci Monit 11(5):RA163-172

    PubMed  Google Scholar 

  9. Singh SD, Ajani UA, Johnson CJ et al (2011) Association of cutaneous melanoma incidence with area-based socioeconomic indicators-United States, 2004–2006. J Am Acad Dermatol 65(5 Suppl 1):S58-68. https://doi.org/10.1016/j.jaad.2011.05.035

    Article  PubMed  Google Scholar 

  10. Pollitt RA, Clarke CA, Shema SJ, Swetter SM (2008) California Medicaid enrollment and melanoma stage at diagnosis: a population-based study. Am J Prev Med 35(1):7–13. https://doi.org/10.1016/j.amepre.2008.03.026

    Article  PubMed  PubMed Central  Google Scholar 

  11. Clairwood M, Ricketts J, Grant-Kels J, Gonsalves L (2014) Melanoma in skin of color in Connecticut: an analysis of melanoma incidence and stage at diagnosis in non-Hispanic blacks, non-Hispanic whites, and Hispanics. Int J Dermatol 53(4):425–433. https://doi.org/10.1111/j.1365-4632.2012.05713.x

    Article  PubMed  Google Scholar 

  12. Hernandez C, Mermelstein RJ (2009) A conceptual framework for advancing melanoma health disparities research. Arch Dermatol 145(12):1442–1446. https://doi.org/10.1001/archdermatol.2009.316

    Article  PubMed  Google Scholar 

  13. Andreeva VA, Unger JB, Yaroch AL, Cockburn MG, Baezconde-Garbanati L, Reynolds KD (2009) Acculturation and sun-safe behaviors among US Latinos: findings from the 2005 Health Information National Trends Survey. Am J Public Health 99(4):734–741. https://doi.org/10.2105/AJPH.2007.122796

    Article  PubMed  PubMed Central  Google Scholar 

  14. Heckman CJ, Coups EJ, Manne SL (2008) Prevalence and correlates of indoor tanning among US adults. J Am Acad Dermatol 58(5):769–780. https://doi.org/10.1016/j.jaad.2008.01.020

    Article  PubMed  PubMed Central  Google Scholar 

  15. Centers for Disease Control and Prevention (CDC) (2007) Sunburn prevalence among adults–United States, 1999, 2003, and 2004. MMWR Morb Mortal Wkly Rep 56(21):524–528

    Google Scholar 

  16. Pipitone M, Robinson JK, Camara C, Chittineni B, Fisher SG (2002) Skin cancer awareness in suburban employees: a Hispanic perspective. J Am Acad Dermatol 47(1):118–123. https://doi.org/10.1067/mjd.2002.120450

    Article  PubMed  Google Scholar 

  17. Ma F, Collado-Mesa F, Hu S, Kirsner RS (2007) Skin cancer awareness and sun protection behaviors in white Hispanic and white non-Hispanic high school students in Miami. Florida Arch Dermatol 143(8):983–988. https://doi.org/10.1001/archderm.143.8.983

    Article  PubMed  Google Scholar 

  18. Unger JB, Cruz TB, Rohrbach LA et al (2000) English language use as a risk factor for smoking initiation among Hispanic and Asian American adolescents: evidence for mediation by tobacco-related beliefs and social norms. Health Psychol Off J Div Health Psychol Am Psychol Assoc 19(5):403–410. https://doi.org/10.1037//0278-6133.19.5.403

    Article  CAS  Google Scholar 

  19. Barcenas CH, Wilkinson AV, Strom SS et al (2007) Birthplace, years of residence in the United States, and obesity among Mexican-American adults. Obes Silver Spring Md 15(4):1043–1052. https://doi.org/10.1038/oby.2007.537

    Article  Google Scholar 

  20. Crespo CJ, Smit E, Carter-Pokras O, Andersen R (2001) Acculturation and leisure-time physical inactivity in Mexican American adults: results from NHANES III, 1988–1994. Am J Public Health 91(8):1254–1257. https://doi.org/10.2105/ajph.91.8.1254

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Lara M, Gamboa C, Kahramanian MI, Morales LS, Bautista DEH (2005) Acculturation and Latino health in the United States: a review of the literature and its sociopolitical context. Annu Rev Public Health 26:367–397. https://doi.org/10.1146/annurev.publhealth.26.021304.144615

    Article  PubMed  PubMed Central  Google Scholar 

  22. Boyas JF, Nahar VK (2018) Predictors of sun protective behaviors among Latino day laborers. J Skin Cancer 2018:3454309. https://doi.org/10.1155/2018/3454309

    Article  PubMed  PubMed Central  Google Scholar 

  23. Coups EJ, Stapleton JL, Hudson SV, Medina-Forrester A, Natale-Pereira A, Goydos JS (2012) Sun protection and exposure behaviors among Hispanic adults in the United States: differences according to acculturation and among Hispanic subgroups. BMC Public Health 12:985. https://doi.org/10.1186/1471-2458-12-985

    Article  PubMed  PubMed Central  Google Scholar 

  24. Coups EJ, Stapleton JL, Hudson SV et al (2013) Linguistic acculturation and skin cancer-related behaviors among Hispanics in the southern and western United States. JAMA Dermatol 149(6):679–686. https://doi.org/10.1001/jamadermatol.2013.745

    Article  PubMed  PubMed Central  Google Scholar 

  25. Fox M, Thayer Z, Wadhwa PD (2017) Acculturation and health: the moderating role of socio-cultural context. Am Anthropol 119(3):405–421. https://doi.org/10.1111/aman.12867

    Article  PubMed  PubMed Central  Google Scholar 

  26. Xie Y, Greenman E (2011) The social context of assimilation: testing implications of segmented assimilation theory. Soc Sci Res 40(3):965–984. https://doi.org/10.1016/j.ssresearch.2011.01.004

    Article  PubMed  PubMed Central  Google Scholar 

  27. Gordon MM (1964) Assimilation in American life: the role of race, religion, and national origins. Oxford UNIVERSITY Press, USA

    Google Scholar 

  28. Greenman E (2011) Assimilation choices among immigrant families: does school context matter? Int Migr Rev 45(1):29–67. https://doi.org/10.1111/j.1747-7379.2010.00828.x

    Article  PubMed  PubMed Central  Google Scholar 

  29. Marín G (1992) Issues in the measurement of acculturation among Hispanics. Psychological testing of Hispanics. APA Science Volumes. American Psychological Association, pp 235–251. https://doi.org/10.1037/10115-012

    Chapter  Google Scholar 

  30. Cuellar I, Arnold B, Maldonado R (1995) Acculturation rating scale for Mexican Americans-II: a revision of the original ARSMA scale. Hisp J Behav Sci 17(3):275–304

    Article  Google Scholar 

  31. Cuellar I, Harris LC, Jasso R (1980) An acculturation scale for Mexican American normal and clinical populations. Hisp J Behav Sci 2(3):199–217

    Google Scholar 

  32. Byrd TL, Peterson SK, Chavez R, Heckert A (2004) Cervical cancer screening beliefs among young Hispanic women. Prev Med 38(2):192–197. https://doi.org/10.1016/j.ypmed.2003.09.017

    Article  PubMed  Google Scholar 

  33. Berry JW (2003) Conceptual approaches to acculturation. In: Acculturation: advances in theory, measurement, and applied research. Acculturation: advances in theory, measurement, and applied research. American Psychological Association, pp 17–37. https://doi.org/10.1037/10472-004

    Chapter  Google Scholar 

  34. Cabassa LJ (2003) Measuring acculturation: where we are and where we need to go. Hisp J Behav Sci 25(2):127–146

    Article  Google Scholar 

  35. Magafia J. Raul et al (1996) Revisiting the dimensions of acculturation: cultural theory and psychometric practice. Hisp J Behav Sci 18(4):444–468

    Article  Google Scholar 

  36. Marin G, Gamba RJ (1996) A new measurement of acculturation for Hispanics: the Bidimensional Acculturation Scale for Hispanics (BAS). Hisp J Behav Sci 18(3):297–316

    Article  Google Scholar 

  37. Rogler LH, Cortes DE, Malgady RG (1991) Acculturation and mental health status among Hispanics. Convergence and new directions for research. Am Psychol 46(6):585–597. https://doi.org/10.1037//0003-066x.46.6.585

    Article  CAS  PubMed  Google Scholar 

  38. Ryder AG, Alden LE, Paulhus DL (2000) Is acculturation unidimensional or bidimensional? A head-to-head comparison in the prediction of personality, self-identity, and adjustment. J Pers Soc Psychol 79(1):49–65. https://doi.org/10.1037//0022-3514.79.1.49

    Article  CAS  PubMed  Google Scholar 

  39. Mendoza RH (1989) An empirical scale to measure type and degree of acculturation in Mexican American adolescents and adults. J Cross Cult Psychol 20(4):372–385

    Article  Google Scholar 

  40. Barona A, Miller JA (1994) Short acculturation scale for Hispanic youth (SASH-Y): a preliminary report. Hisp J Behav Sci 16(2):155–162

    Article  Google Scholar 

  41. Marin Gerardo et al (1987) Development of a short acculturation scale for Hispanics. Hisp J Behav Sci 9(2):183–205

    Article  Google Scholar 

  42. Ramirez Amelie G et al (1986) A media-based acculturation scale for Mexican-Americans: application to public health education programs. Fam Community Health 9(3):63–71

    Article  Google Scholar 

  43. Cortés DE, Rogler LH, Malgady RG (1994) Biculturality among Puerto Rican adults in the United States. Am J Community Psychol 22(5):707–721. https://doi.org/10.1007/BF02506900

    Article  PubMed  Google Scholar 

  44. Deyo RA, Diehl AK, Hazuda H, Stern MP (1985) A simple language-based acculturation scale for Mexican Americans: validation and application to health care research. Am J Public Health 75(1):51–55. https://doi.org/10.2105/ajph.75.1.51

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Franco JN (1983) An acculturation scale for Mexican-American children. J Gen Psychol 108(2):175–181. https://doi.org/10.1080/00221309.1983.9711491

    Article  PubMed  Google Scholar 

  46. Hazuda HP, Haffner SM, Stern MP, Eifler CW (1988) Effects of acculturation and socioeconomic status on obesity and diabetes in Mexican Americans: the San Antonio Heart Study. Am J Epidemiol 128(6):1289–1301. https://doi.org/10.1093/oxfordjournals.aje.a115082

    Article  CAS  PubMed  Google Scholar 

  47. Solis JM, Marks G, Garcia M, Shelton D (1990) Acculturation, access to care, and use of preventive services by Hispanics: findings from HHANES 1982–84. Am J Public Health. 80:11–19. https://doi.org/10.2105/ajph.80.suppl.11

    Article  PubMed  PubMed Central  Google Scholar 

  48. Wallen GR, Feldman RH, Anliker J (2002) Measuring acculturation among Central American women with the use of a brief language scale. J Immigr Health 4(2):95–102. https://doi.org/10.1023/A:1014550626218

    Article  PubMed  PubMed Central  Google Scholar 

  49. Cortés DE, Deren S, Andía J, Colón H, Robles R, Kang SY (2003) The use of the Puerto Rican Biculturality Scale with Puerto Rican drug users in New York and Puerto Rico. J Psychoactive Drugs 35(2):197–207. https://doi.org/10.1080/02791072.2003.10400001

    Article  PubMed  Google Scholar 

  50. Zea MC, Asner-Self KK, Birman D, Buki LP (2003) The abbreviated multidimensional acculturation scale: empirical validation with two Latino/Latina samples. Cultur Divers Ethnic Minor Psychol 9(2):107–126. https://doi.org/10.1037/1099-9809.9.2.107

    Article  PubMed  Google Scholar 

  51. Abraído-Lanza AF, Armbrister AN, Flórez KR, Aguirre AN (2006) Toward a theory-driven model of acculturation in public health research. Am J Public Health 96(8):1342–1346. https://doi.org/10.2105/AJPH.2005.064980

    Article  PubMed  PubMed Central  Google Scholar 

  52. Guendelman S, Abrams B (1995) Dietary intake among Mexican-American women: generational differences and a comparison with white non-Hispanic women. Am J Public Health 85(1):20–25. https://doi.org/10.2105/ajph.85.1.20

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Van Voorhees BW, Paunesku D, Kuwabara SA et al (2008) Protective and vulnerability factors predicting new-onset depressive episode in a representative of U.S. adolescents. J Adolesc Health 42(6):605–616. https://doi.org/10.1016/j.jadohealth.2007.11.135

    Article  PubMed  Google Scholar 

  54. Thomson MD (1982) Hoffman-Goetz L (2009) Defining and measuring acculturation: a systematic review of public health studies with Hispanic populations in the United States. Soc Sci Med 69(7):983–991. https://doi.org/10.1016/j.jadohealth.2007.11.135

    Article  Google Scholar 

  55. Heckman CJ, Cohen-Filipic J (2012) Brief report: ultraviolet radiation exposure, considering acculturation among Hispanics (project URECAH). J Cancer Educ Off J Am Assoc Cancer Educ 27(2):342–346. https://doi.org/10.1007/s13187-011-0308-x

    Article  Google Scholar 

  56. Rodríguez VM, Shuk E, Arniella G et al (2017) A qualitative exploration of Latinos’ perceptions about skin cancer: the role of gender and linguistic acculturation. J Cancer Educ Off J Am Assoc Cancer Educ 32(3):438–446. https://doi.org/10.1007/s13187-015-0963-4

    Article  Google Scholar 

  57. Viola AS, Stapleton JL, Coups EJ (2019) Associations between linguistic acculturation and skin cancer knowledge and beliefs among U.S. Hispanic adults. Prev Med Rep 15:100943. https://doi.org/10.1016/j.pmedr.2019.100943

    Article  PubMed  PubMed Central  Google Scholar 

  58. McKesey J, Berger TG, Lim HW, McMichael AJ, Torres A, Pandya AG (2017) Cultural competence for the 21st century dermatologist practicing in the United States. J Am Acad Dermatol 77(6):1159–1169. https://doi.org/10.1016/j.jaad.2017.07.057

    Article  PubMed  Google Scholar 

  59. García AA, Zuñiga JA, Lagon C (2017) A Personal touch: the most important strategy for recruiting Latino research participants. J Transcult Nurs Off J Transcult Nurs Soc 28(4):342–347. https://doi.org/10.1177/1043659616644958

    Article  Google Scholar 

  60. Reidy MC, Orpinas P, Davis M (2012) Successful recruitment and retention of Latino study participants. Health Promot Pract 13(6):779–787. https://doi.org/10.1177/1524839911405842

    Article  PubMed  Google Scholar 

  61. Karliner LS, Jacobs EA, Chen AH, Mutha S (2007) Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health Serv Res 42(2):727–754. https://doi.org/10.1111/j.1475-6773.2006.00629.x

    Article  PubMed  PubMed Central  Google Scholar 

  62. Assessing change: evaluating cultural competence education & training. AAMC. Accessed October 5, 2023. https://www.aamc.org/what-we-do/equity-diversity-inclusion/learning/assessing-change

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Authors and Affiliations

  1. Eastern Virginia Medical School, Norfolk, VA, USA

    Yanci A. Algarin

  2. University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA

    Anika Pulumati

  3. Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA

    Yanci A. Algarin, Dana Jaalouk, Anika Pulumati & Keyvan Nouri

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Algarin, Y.A., Jaalouk, D., Pulumati, A. et al. The Impact of Acculturation on Skin Cancer Risk and Protective Behaviors in Hispanic Populations. J Canc Educ (2024). https://doi.org/10.1007/s13187-024-02413-0

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