This cross-sectional study evaluated the knowledge, attitudes, and practices regarding skin cancer and sun exposure among homeless men (n = 75). A 21-item survey was given to men residing at Calvert Place Men’s Shelter in Dallas, TX. Results indicated that 49% knew that a change in a mole’s appearance and a sore that does not heal were signs of skin cancer. Black homeless men were less likely to know that people with dark skin could get skin cancer and that sunscreen should be applied 15–30 min before sun exposure compared to white and other subgroups (p < .05). People were more likely to agree that sun protection is important (median = 5.0), but less likely to agree that they were at risk for skin cancer (median = 3.0). White men had higher levels of agreement that melanoma was dangerous compared to other racial/ethnic groups (p = 0.0224). Over half (52%) of individuals reported being in the sun often, yet only 21% reported the use of sunscreen. Most (71%) homeless men had never checked themselves for skin cancer and only 13% reported ever being screened by a health professional for skin cancer. Increased skin cancer education and increased screening efforts should be implemented to better protect the homeless population at Calvert Place from skin cancer.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
sun protection factor
U.S. Department of Health and Human Services (2014) The surgeon General’s call to action to prevent skin Cancer. U.S. Dept of Health and Human Services, Office of the Surgeon General, Washington, DC
American Cancer Society (2018) Cancer Facts & Figures 2018. American Cancer Society, Atlanta
Buster KJ, You Z, Fouad M, Elmets C (2012) Skin cancer risk perceptions: a comparison across ethnicity, age, education, gender, and income. J Am Acad Dermatol 66(5):771–779. https://doi.org/10.1016/j.jaad.2011.05.021
Metro Dallas Homeless Alliance (2018) State of the Homeless Address 2018. Metro Dallas Homeless Alliance, Dallas
U.S. Environmental Protection Agency (2017) Sun safety monthly average UV index. U.S. Environmental Protection Agency, Stratospheric Protection Division, Washington, DC
Grossberg AL, Carranza D, Lamp K, Chiu MW, Lee C, Craft N (2012) Dermatologic care in the homeless and underserved populations: observations from the Venice Family Clinic. Cutis 89(1):25–32
Wilde MJ, Jones B, Lewis BK, Hull CM (2013) Skin cancer screening in the homeless population. Dermatol Online J 15(19(1)):14
Truong A, Laggis C, Gardner L, Forbes B, Powell D, Vranes C, Annis T, Gregory T, Hull C, Lewis B (2018) Evaluation of skin cancer diagnoses in dermatology patients seen in a homeless clinic. J Investig Dermatol 138(5):S44–S44
Williams LB, McCall A, Looney SW, Joshua T, Tingen MS (2018) Demographic, psychosocial, and behavioral associations with cancer screening among a homeless population. Public Health Nurs 35:281–290. https://doi.org/10.1111/phn.12391
Day AK, Wilson C, Roberts RM, Hutchinson AD (2014) The skin cancer and sun knowledge (SCSK) scale: validity, reliability, and relationship to sun-related behaviors among young western adults. Health Educ Behav 41(4):440–448. https://doi.org/10.1177/1090198114529129
Patel SS, Nijhawan RI, Stechschulte S, Parmet Y, Rouhani P, Kirsner RS, Hu S (2010) Skin cancer awareness, attitude, and sun protection behavior among medical students at the University of Miami Miller School of medicine. Arch Dermatol 146(7):797–800. https://doi.org/10.1001/archdermatol.2010.140
Meh C, Gill J, Kim DH (2010) A comparison of skin cancer knowledge, attitude, and protective behavior in AA students in east and west coasts. Calif J Health Promot 11(3):25–35
Glanz K, Yaroch A, Dancel M, Saraiya M, Crane LA, Buller DB, Manne S, O'Riordan DL, Heckman CJ, Hay J, Robinson JK (2008) Measures of sun exposure and sun protection practices for behavioral and epidemiologic research. Arch Dermatol 144(2):217–222
Ho BK, Robinson JK (2015) Color bar tool for skin type self-identification: a cross sectional study. J Am Acad Dermatol 73(2):312–313.e1. https://doi.org/10.1016/j.jaad.2015.05.024
DeHaven M, Gimpel N, Dallo F, Billmeier T (2011) Reaching the underserved through community-based participatory research (CBPR) and service learning: description and evaluation of a unique medical student training program. J Public Health Manag Pract 17(4):363–368
Chau S, Chin M, Chang J, Luecha A, Cheng E, Schlesinger J et al (2002) Cancer risk behaviors and screening rates among homeless adults in Los Angeles County. Cancer Epidemiol Biomark Prev 11:431–438
Lakhani NA, Saraiya M, Thompson TD, King SC, Guy GP (2014) Total body skin examination for skin cancer screening among U.S. adults from 2000 to 2010. Prev Med 61:75–80. https://doi.org/10.1016/j.ypmed.2014.01.003
National Cancer Institute (2017) Do you ever check your skin for signs of skin cancer? Health Information National Trends Survey 5. Cycle 1 [Data file]. Retrieved from https://hints.cancer.gov/view-questions-topics/question-details.aspx?PK_Cycle=10&qid=1687. Accessed 8 March 2019
USPSTF, Bibbins-Domingo K, Grossman DC et al (2016) Screening for skin cancer: US preventive services task force recommendation statement. JAMA 316(4):429–435. https://doi.org/10.1001/jama.2016.8465
American Cancer Society (2018) Skin exams. American Cancer Society, Atlanta. Available at https://www.cancer.org/cancer/skin-cancer/prevention-and-early-detection/skin-exams.html. Accessed 8 March 2019
Pichon LC, Corral I, Landrine H, Mayer JA, Adams-Simms D (2010) Perceived skin cancer risk and sunscreen use among African American adults. J Health Psychol 15(8):1181–1189. https://doi.org/10.1177/1359105310364177
Cheng CE, Irwin B, Mauriello D, Hemminger L, Pappert A, Kimball AB (2010) Health disparities among different ethnic and racial middle and high school students in sun exposure beliefs and knowledge. J Adolesc Health 47(1):106–109. https://doi.org/10.1016/j.jadohealth.2009.12.028
Temoshok L, DiClemente RJ, Sweet DM, Blois MS, Sagebiel RW (1984) Prognostic and psychosocial factors related to delay behavior in patients with cutaneous malignant melanoma. Prog Clin Biol Res 156:169–179
Tsai S, Frank SH, Bordeaux JS (2018) Improving sun-protective behaviors and self-skin examinations among African Americans: a randomized controlled trial. Dermatol Surg 44(4):512–518. https://doi.org/10.1097/DSS.0000000000001366
Chung GY, Brown G, Gibson D (2015) Increasing melanoma screening among Hispanic/Latino Americans. Health Educ Behav 42(5):627–632. https://doi.org/10.1177/1090198115578748
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Joseph, A., Kindratt, T., Pagels, P. et al. Knowledge, Attitudes, and Practices Regarding Skin Cancer and Sun Exposure among Homeless Men at a Shelter in Dallas, TX. J Canc Educ 35, 682–688 (2020). https://doi.org/10.1007/s13187-019-01511-8
- Skin neoplasms
- Sun exposure