Hispanic and Latino Ethnicity and Acculturation: Influences on Skin Cancer Prevention Attitudes and Behaviors.

Abstract

Hispanic and Latino (H/L) populations are among the fastest-growing minority groups in the United States (US), projected to collectively reach 27.5% of the population by 2060. Despite a lower melanoma incidence compared to non-Hispanic White (NHW) individuals, H/L individuals face disproportionately higher disease burdens, including later-stage diagnoses and worse prognoses. While differences in sun-protective behaviors and UV exposure have been noted between H/L and NHW populations, the role of acculturation-a process by which individuals adopt the cultural norms of a dominant society-remains underexplored in dermatologic health. A cross-sectional survey study was conducted from August 2023 to August 2024 of adult patients capable of providing informed consent and fluent in English or Spanish. The survey included 32 questions covering sociodemographic data, the validated Short Acculturation Scale for Hispanics, and items adapted from prior sun protection behavior studies. A total of 257 responses were collected; 160 respondents (62%) self-identified as H/L, and 141 (55%) were born outside the United States. H/L participants were more likely than non-H/L respondents to avoid peak sun exposure hours (P=0.003) and to wear hats (P=0.03). Among H/L respondents, higher acculturation scores were significantly associated with increased use of sunglasses (P<0.001) and daily water intake (P=0.002). However, overall acculturation did not influence 83.3% of surveyed health behaviors. Socioeconomic status was a stronger predictor of sun-protective practices; H/L participants from lower socioeconomic backgrounds were less likely to perform or be aware of self-skin examinations (P=0.01) and less likely to wear sunglasses (P=0.08). H/L individuals were approximately 20% less likely than non-H/L participants to perform regular self-skin exams (relative risk: 0.81; 95% confidence interval: 0.62-1.05). Contrary to prior assumptions, acculturation to US culture showed limited influence on most sun-protective behaviors among H/L adults in this study. Instead, socioeconomic disparities and occupational exposure-particularly in high UV-risk industries such as agriculture and construction-may contribute more directly to increased melanoma burden in this population. These findings underscore the need for dermatologic public health strategies that consider socioeconomic and occupational risk factors alongside cultural dynamics. Future multicenter studies are recommended to further explore these relationships and to improve skin cancer prevention efforts in H/L communities.