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Outdoor Workers Not Screened for Skin Cancer, Research Says

New research has determined that employees working outdoors in the construction, forestry, fishing or farming industries are least likely to receive skin exams, despite their increased risk of incurring skin cancer from regular exposure to the sun's harmful ultraviolet rays.

In a study published online in the Journal of the American Academy of Dermatology, dermatologist Robert Kirsner, professor and vice chairman of the departments of dermatology and cutaneous surgery at the University of Miami Miller School of Medicine in Miami, and his colleagues used the National Health Interview Survey (NHIS) data from 2000 and 2005 to estimate the percentage of U.S. workers who fell into two categories: those who received a skin exam during an appointment with a primary health care provider within the past 12 months and those who had a skin exam in their lifetimes.

According to Dr. Kirsner, previous studies demonstrated that high-risk populations such as outdoor workers don't frequently receive “total-body screening examinations” by primary case physicians.

“As dermatologists, we know that the early detection of skin cancer by routine skin examinations is crucial in successfully treating this potentially life-threatening condition – particularly for workers routinely exposed to harmful ultraviolet light,” Kirsner said. “ This study shows that workers who need careful monitoring for skin cancer due to the nature of their jobs are less likely to receive skin exams than workers in low-risk occupations.”

Conducted by the National Center for Health Statistics (NCHS), the NHIS is an annual, cross-sectional, in-person household survey of U.S. workers. In 2000 and 2005, the Cancer Control Module was included as part of the NHIS and contained questions on skin examinations that were administered to 19,702 and 18,422 employed participants, respectively.

Kirsner concluded that when he and his colleagues examined the data for the 38,124 study participants, “only 15 percent of all U.S. workers reported ever receiving a skin examination during their lifetime, and only 8 percent of those who also had seen a health care provider in the past year reported that they had received a skin exam during that time.”

He added that occupational groups at increased risk for exposure to UV light on the job were less likely to have ever received a skin examination in their lifetime than the average U.S. worker. This included:

  • farm operators and managers (10 percent);
  • farm workers and other agricultural workers (7 percent);
  • forestry and fishing occupations (3 percent);
  • construction and mining trades (8 percent); and
  • construction laborers (8 percent).

Kirsner concluded that socioeconomic factors played a role, adding that younger black or Hispanic women without health insurance who were farm, service or blue-collar workers not using any sun protection were the least likely to report ever having been screened for skin cancer.

Kirsner emphasized that all patients, regardless of their occupations, should ask their physician to provide skin exams during their routine check up. He also suggested that developing and implementing local community health fairs that include screening programs targeting high-risk workers could be helpful.

For more information about skin cancer, visit the SkinCancerNet section on, a Web site developed by dermatologists that provides patients with up-to-date information on the treatment and management of disorders of the skin, hair and nails. The Academy’s National Melanoma/Skin Cancer Screening Program offers free skin cancer screenings. Visit to learn more.

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