title: Veterans Speak Up: Current Warnings on Skin Cancer Miss the Target, Suggestions for Improvement.
abstract: BACKGROUND
  Skin cancer is the most common cancer in the world and its incidence is increasing. Veterans may have increased exposure to risk factors, but data are lacking in terms of their perceptions of skin cancer and the types of prevention strategies that might resonate with this population.
  
  
  OBJECTIVE
  This study examines veterans' awareness of the risk factors for skin cancer and importance of sun protection and seeks to identify effective communication and educational strategies for this at-risk population.
  
  
  METHODS
  A telephone survey was conducted of 100 veterans, who have been diagnosed with skin cancer at the Audie Murphy Veteran's Hospital in San Antonio, Texas.
  
  
  RESULTS
  The majority of respondents' said that their skin cancer resulted from sun exposure and that the best way to prevent skin cancer was to use sunscreen. However, when asked if they believed they were at risk for being diagnosed with skin cancer, most veterans responded that they believed they were at little risk. In response to why veterans did not heed warnings about skin cancer, many replied that they believed skin cancer would not happen to them. A statistically significant increase in usage of sunscreen and sun protectant garments occurred after being diagnosed with skin cancer and education by their physicians. Doctors talking to patients was rated the most effective communication method to inform them about the risks of skin cancer, followed by education during basic training.
  
  
  CONCLUSIONS
  Recall bias is the major limitation with a retrospective survey design.
  
  
  CONCLUSIONS
  Our results reveal poor patient awareness of the risks of skin cancer and the benefits of sun protection before their diagnosis. The veterans agreed that the physician-patient interaction is the best and most effective means of communication, which is evident by the significant increase in sun protection and sunscreen usage after their diagnosis. Our survey revealed that other effective communication strategies included education in basic training, the use of a veteran spokes model with skin cancer, and the use of images to emphasize the severity of the disease.
authors.affiliation: University of Texas Health Science Center, San Antonio, Division of Dermatology and Cutaneous Surgery, Cancer Therapy Research Center (CTRC), 7979 Wurzbach Road, Mail Code 7876, San Antonio, TX 78229-4427.
authors.forename: Valerie
authors.initials: V
authors.lastname: Fisher
authors.affiliation: University of Texas Health Science Center, San Antonio, Division of Dermatology and Cutaneous Surgery, Cancer Therapy Research Center (CTRC), 7979 Wurzbach Road, Mail Code 7876, San Antonio, TX 78229-4427.
authors.forename: Deborah
authors.initials: D
authors.lastname: Lee
authors.affiliation: Audie L. Murphy Veteran's Hospital, Department of Dermatology, 7400 Merton Minter, San Antonio, TX 78229.
authors.forename: John
authors.initials: J
authors.lastname: McGrath
authors.affiliation: University of Texas Health Science Center, San Antonio, Division of Dermatology and Cutaneous Surgery, Cancer Therapy Research Center (CTRC), 7979 Wurzbach Road, Mail Code 7876, San Antonio, TX 78229-4427.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Krejci-Manwaring
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D008297:Male; D011481:Protective Clothing / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D013472:Sunlight / Q000009:adverse effects*; D013473:Sunscreening Agents / Q000494:pharmacology*; D013781:Texas / Q000453:epidemiology; D014728:Veterans
chemical_list: D013473:Sunscreening Agents