Skin cancer and actinic keratoses

Skin cancer is the most common cancer among whites and is increasing faster than most other cancers. Non-melanoma skin cancers are typically slow-growing, but in the periocular region they are more aggressive. If not treated early, malignant melanoma is almost always lethal. Optometrists can play an important role in the early detection of skin cancer.

One thousand (1,000) consecutive patients, ages 35 and older, were screened for skin cancer and actinic keratoses of the head and neck. Patients were also questioned for any previous diagnoses for these conditions. The screenings were done as part of an optometric examination in a private practice in southeastern Pennsylvania.

Ninety-six (96) white patients had a previous diagnosis of skin cancer or actinic keratoses. Three additional patients were diagnosed with one of these conditions as part of this study. From this total of ninety-nine (99) positive patients, all had skin cancer-except three (3), who had actinic keratoses. Of the white patients, 10.3% were positive, none of the 41 blacks nor the one Asian had any history. More males reported these conditions than females (12.8% vs. 8.6). The head and neck was the most common site reported (69.7%).

A large number of white patients in this primary care optometric practice were positive for skin cancer or actinic keratosis. Optometrists should seriously consider screening the exposed skin of their older white patients.