Use of skin-cancer prevention strategies among farmers and their spouses.

Epidemiologic studies show that farmers are at increased risk of skin cancer, presumed to be secondary to the increased time they spend outdoors with exposure to the sun. We surveyed a random sample of farmers and their spouses 40 years of age or older from four rural counties in Michigan on their knowledge, attitudes, and behavior regarding protection of their skin from the sun and screening medical exams for skin cancer. Questionnaires were completed by 1,342 farmers and their spouses. This was a response rate of 63.5%. Eighty to ninety percent knew the changes in the skin that could indicate cancer and required medical follow-up. Only 40% of the men and 65% of the women were likely to protect their skin when they went outdoors. Increasing age and personal history of skin cancer increased the likelihood of both men and women protecting their skin when they went outside. Additionally, higher-income women were likely to use sun protection. Despite the fact that 90% of the respondents had had a physical examination in the last three years, less than one third reported ever having had their skin examined for cancer. Increasing age, income, and education increased the likelihood of having had such an exam. The majority of those who had had a skin exam had the exam for a particular skin problem, and not as part of a routine physical examination. Farmers and their spouses need to increase their use of sun protection when going outside. Additionally, health care providers need to routinely include examination of the skin for skin cancer and alert their patients that it is being performed.