INTRODUCTION
The latest 2010 United States Census indicates that 2.9 million people identify as Native American (NA). Forty-one percent live in the Western states (Arizona, California, Colorado, Montana, Nevada, New Mexico, Alaska, Hawaii, Idaho, Oregon, Utah, Washington, Wyoming).1 Despite the prevalence of NA residing in these UV-intense geographic regions, there is very limited data on skin cancer in this population.In the last 20 years, only 11 publications have mentioned NA sun protection behavior and skin cancer prevalence. Herein, we aim to fill the knowledge gap on skin cancer epidemiology and sun protection behaviors in NA.
MATERIALS AND METHODS
Between 2017-2018, an anonymous questionnaire was deployed to adult NA participants both in person at a dermatology clinic in Tucson, AZ, a local community powwow, and via email listservs and Facebook groups (Indians into Medicine, NA Student Affairs, and American Indian Science and Engineering Society, and NA Research Network). The questionnaire explored demographics, sunscreen use and preference, skin cancer screening, and personal and family history. Inclusion criteria included participants >18 years of age who self-identified as a NA member of a federally recognized tribe with a history of residing on a reservation. This study was approved and exempted by the University of Arizona Institutional Review Board.
RESULTS
Respondents were 159 federally recognized NA tribal members (87% female, mean age: 31.9, SD, 10.4, range, 18-67). Allrespondents have lived on a reservation (mean, 20.0 years, SD,11.1, range, 1-67).Eighty-seven percent (n=139) had been sunburned at least once, most commonly associated with skin redness (90%, n=125), peeling (82%, n=114), swelling (9%, n=12), blistering (7%, n=10), and scabbing (4%, n=6). Despite the prevalence of sunburns,only 10.7% (n=17) of participants reported regular sunscreen use (multiple times a day or once daily) on their body (Table 1). The most common reason for sunscreen use was to prevent sunburn, followed by prevention of skin cancer, sunspots, or