American Indians and Alaskan Natives (AIAN) were found to practice few skin cancer prevention behaviors, according to a research letter published in the Journal of the American Academy of Dermatology.

In the United States, more than 9 million residents are part of AIAN communities. Although AIANs represent a significant proportion of its residents, few studies related to skin cancer conducted in the US focus on AIANs.

To address the paucity of data, investigators from Brigham and Woman’s Hospital analyzed skin cancer screening data using the National Health Interview Survey conducted between 2005 and 2015.

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Among a total study population of 360,573 US residents, 5148 were AIAN.

Compared with other ethnicities, AIAN respondents were less likely to report wearing a hat on a sunny day (z-score range, −4.32 to −1.93; all P <.001). They were also less likely to wear sunscreen compared with Whites (z-score, −13.9; P <.001) and seek shade compared with Asians (z-score, −2.83; P <.001).

Compared with Whites, AIANs reported more severe skin effects when spending more than an hour in the sun (z-score, 13.35; P <.001). Risky behaviors such as using indoor tanning was more common among AIANs compared with Blacks or Asians (odds ratio [OR] range, 14.8-17.4; both P <.001).

A personal history of melanoma was more common among AIANs than Blacks (OR, 4.9; 95% CI, 4.18-5.36; P <.001) and Asians (OR, 6.3; 95% CI, 5.8-7.2; P =.03) and a personal history of non-melanoma skin cancer was less likely among AIANs than Whites (OR, 0.05; 95% CI, 0.01-0.24; P <.001).

The study authors concluded, “Our results suggest that AIANs may be a population that engages in few skin cancer prevention behaviors in the United States. Notably, AIANs reported a higher propensity to burn, engaged in more frequent indoor tanning behaviors, and had higher rates of melanoma diagnosis compared with other minority groups.”


Yang K, Pan CX, Kassamali B, Zhou G, LaChance AH, Nambudiri VE. Sun-protective behaviors and skin cancer risk factors among American Indians and Alaskan Natives in the United States. J Am Acad Dermatol. Published online August 15, 2022. doi:10.1016/j.jaad.2022.06.035