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Abstract
Background: Firefighters have an increased risk of skin cancer compared to the general population, possibly due to occupational exposures (1). Limited awareness and knowledge of skin cancer may result in delayed diagnosis. Objectives: To understand the prevalence of skin cancer risk factors among firefighters and to measure skin cancer attitudes, knowledge, and confidence in performing self-skin exams before and after a screening intervention.
Methods: Firefighters in Boston, Massachusetts attended a voluntary skin cancer screening in 2022 and 2023. Participants were surveyed on sun practices, skin cancer risk factors, and attitudes surrounding skin cancer. Skin cancer knowledge was assessed via a 10-question quiz. Differences in attitudes, knowledge, and confidence in performing self-skin exams among firefighters who attended two screenings were compared to those who only attended one.
Results: There were 875 participants; 707 attended one screening and 168 attended two. Overall, 16.5% reported using sunscreen “rarely” or “never”, and 29.0% reported using sun-protective clothing “rarely” or “never.” Four or more blistering sunburns before age 20 were reported by 29.4%, and 17.1% had used tanning beds. Those who attended two screenings were more likely to report confidence with self-skin exams (p = 0.016) and had higher knowledge quiz scores (p = 0.005) compared to those who attended one.
Conclusion: A large proportion of Boston firefighters have significant risk factors for skin cancer. Skin cancer screening participation may increase knowledge about skin cancer, increase confidence surrounding skin self-examination, and motivate participants to engage in self-education, all of which may improve self skin-exam performance and facilitate earlier cancer detection.