From Above and Below: How Cancer Risk Perception from Sun and Seafood Consumption Impacts Preventive Care Utilization
Underlined: presenting authors
Background
Urban fishers are uniquely vulnerable to intersecting threats that pattern increased cancer risk and poor prognosis, specifically prolonged ultraviolet radiation (UVR) exposure from increasingly frequent extreme heat days and heightened exposure to carcinogenic environmental contaminants through seafood consumption. We conducted a mixed-methods investigation to understand how perception of UVR and heavy metal exposure risk, both alone and in combination, informs sun-protective behaviors (SPBs), preventive care utilization, and skin cancer (SC) screening adherence.
Methods
Semi-structured interviews were conducted in English, Spanish, and Haitian Kreyol among near-shore urban fishers in Miami-Dade County, Florida’s largest coastal county by population. Survey questionnaires asked approximately 35 multiple-choice, true/false, and Likertscale questions covering sociodemographic traits, fishing motivations and practices, UVR and heavy metal risk perception, and frequency and purpose of preventive care utilization. Interview data and corresponding field notes were analyzed using rapid qualitative methodology to identify emergent themes.
Results
We found that urban fishers rely on lived experiences and years of accumulated fishing expertise rather than expert opinion for best practices regarding UVR exposure and SC prevention. Despite excessive UVR exposure, participants reported insufficient and inconsistent SPBs and lack of adherence to SC screening recommendations. Further, participants expressed little concern about cancer risk patterned by seafood consumption, thus no impact was reported on healthcare utilization or screening adherence.
Discussion and Conclusion
We found poor evidence of adoption of sun-protective behaviors and inconsistent preventive care utilization, including SC screening. Despite elevated, intersecting health risks among recreational fishers, there is limited research examining the influence of risk perception of carcinogenic exposures on cancer-related health protective behaviors among this population. Awareness of the multifactorial nature of health risks among urban fishers provides a critical foundation to improve SPBs, preventive healthcare utilization, cancer screening adherence among this high-risk population.