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A new survey from the Stanford University School of Medicine suggests that a significant number of Asian Americans living in California adopt unhealthy sun-exposure behaviors as they become more westernized. The findings underscore a need for increased skin health awareness on the part of primary care physicians, dermatologists and people of Asian ancestry, who may incorrectly assume that pigmented skin and hair protect against skin cancer.
"Skin screening and self-examination recommendations, which are often targeted more to people with fair skin, should definitely include different ethnic groups," said dermatologist Anne Chang, MD, an instructor at the medical school, who noted that skin cancer rates have been reported to be rising significantly in Asians living in Singapore and Japan. "Asian Americans shouldn't derive a false sense of security from the presence of skin and hair pigmentation."
Chang and her colleagues surveyed the attitudes and behaviors of 546 Asian Americans in the study, which will be published in the May issue of the Archives of Dermatology. Study participants filled out an Internet-based questionnaire asking, among other things, about their skin type, their degree of westernization and the amount of time spent tanning outdoors or in tanning booths. More than 95% of the responses came from Northern California. In 2007, roughly one of every 10 Californians, or about 4.5 million people, was Asian American.
After correcting for age and skin type, the researchers found that respondents who were more westernized—a measure assessed by number of generations the respondent's family has lived in the United States, whether the respondent was raised mostly in Asia or the United States and how westernized he or she felt—were more likely to feel that a tan was attractive, that sunscreen was too much trouble to apply and that sun-protective clothing was less important than looking fashionable.
According to the survey responses, the more westernized Asian Americans also spent more time in the sun and were more likely to actively tan either outdoors or on tanning beds than respondents categorized as less westernized. Specifically, about 60% of the 312 respondents whose families have been in the United States for at least two generations reported lying in the sun—a rate approaching that of Caucasian Americans—to achieve a tan compared to 47% of the 234 first-generation respondents.