Veterans are at greater risk for sunburn and skin cancer when compared with the nonveteran population, a new study shows.
For the study, researchers culled population-based cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, comprising 61 307 participants (54 554 nonveterans and 6753 veterans).
The main finding? There was a higher prevalence of any skin cancer history among U.S. veterans compared with nonveterans, 9.0% vs 2.9%, respectively, and a higher prevalence of melanoma history among U.S. veterans compared with nonveterans, 2.2% vs 0.6%, respectively, the study showed.
What’s more, veterans were more likely to work outdoors and less likely to use sunscreen freely, stay in the shade, or wear long-sleeve shirts outdoors on a sunny day. Veteran status was associated with a 44% to 45% increased risk of severe sunburn after half an hour in the sun, even after adjusting for demographic factors.
Veterans had a higher prevalence of a psoriasis diagnosis and a 61% higher odds of a psoriasis diagnosis compared with nonveterans, the researchers report. By contrast, veterans did not have an increased odds of having eczema/dermatitis/inflamed rash in the past 30 days anywhere on the body compared with nonveterans. Still, they did have a statistically significant increased odds when localized to the arms.
The study is published in JAMA Dermatology.
“Public health measures can mitigate modifiable skin condition risks affecting this patient population,” conclude the researchers led by Shawheen Rezaei, MPhil, an MD Candidate & Knight-Hennessy Scholar at Stanford School of Medicine in Palo Alto, CA.
“Strategies to reduce skin exposure to UV radiation should be strongly considered for primary prevention in occupational settings, including for active military personnel. Improved adherence to primary preventive measures, such as physical protection with UV protective clothing or topical protection with sunscreen, among military personnel could reduce the risk of skin cancer development later in life.”
“Dermatologists should be aware that veterans face higher skin cancer risks even after adjusting for demographic differences, potentially due, at least in part, to occupational exposures,” writes Rebecca I. Hartman, MD, MPH, an Assistant Professor of Dermatology at Brigham and Women’s Hospital and Harvard Medical School in Boston, MA, and colleagues in an editorial accompanying the new study. “Specifically, additional research is needed to identify and quantify the effects of UV and military toxic exposures on skin cancer risk among active duty service members to generate targeted preventive and diagnostic approaches.”
Strategies to improve access to dermatologic care among veterans should include expanding teledermatology efforts and training primary care practitioners in rural areas to help appropriately triage skin cancers in this population, they wrote.
