Skin cancer and actinic keratoses

Area of Science:

• Ophthalmology
• Dermatology
• Public Health

Background:

• Skin cancer is a prevalent and increasing cancer type, particularly among white populations.
• Non-melanoma skin cancers in the periocular region can be aggressive.
• Malignant melanoma, if untreated, is often fatal, highlighting the need for early detection.

Purpose of the Study:

• To assess the prevalence of skin cancer and actinic keratoses in patients aged 35 and older within a primary care optometric setting.
• To evaluate the role of optometrists in identifying these conditions during routine examinations.

Main Methods:

• A screening of 1,000 consecutive patients (ages 35+) for skin cancer and actinic keratoses of the head and neck.
• Inclusion of patient history regarding previous diagnoses of these conditions.
• Screenings conducted as part of standard optometric examinations in southeastern Pennsylvania.

Main Results:

• Ninety-nine patients (9.9% of total screened) had a prior diagnosis or were newly diagnosed with skin cancer or actinic keratoses.
• Of the positive cases, 96.97% had skin cancer, and 3.03% had actinic keratoses.
• White patients showed a 10.3% prevalence; no cases were found in Black or Asian patients. Males (12.8%) were more affected than females (8.6%). The head and neck region was the most frequently affected site (69.7%).

Conclusions:

• A significant proportion of older white patients in primary care optometric practices present with skin cancer or actinic keratoses.
• Optometrists are well-positioned to screen exposed skin areas of older white patients for early detection of these conditions.