Enhancing Early Detection: A Community-Based Skin Cancer Screening Initiative at the Fourth Street Clinic

Title: Enhancing Early Detection: A Community-Based Skin Cancer Screening Initiative at the Fourth Street Clinic
Authors: Justin Lyon, Addy Kirkham, Adriene Pavek, Bethany K. H. Lewis MD, PhD
Date: 1/27/2025
Abstract: Non-melanoma skin cancers (NMSC), including basal and squamous cell carcinoma, are the most commonly diagnosed cancers in the United States, with approximately 5.4 million cases diagnosed annually. The rising prevalence of skin cancer over the past two decades may be attributed to increased surveillance, greater sun exposure, and longer patient lifespans. While NMSCs are rarely life-threatening due to their low metastatic potential and high curability rates, individuals experiencing homelessness have been shown to have a delayed time to diagnosis, increasing their risk for poor prognostic factors. Current dermatologic literature underscores the importance of annual skin cancer surveillance for high-risk populations to enable early detection and reduce melanoma- related mortality. In response to this growing need, the Fourth Street Clinic (4SC) in Salt Lake City, UT, partnered with the American Academy of Dermatology (AAD) to provide annual skin cancer screenings for this underserved population. Patients were scheduled for screenings through phone calls and walk-in requests. Awareness of the event was spread through local health fairs, flyers, and word of mouth. Staffing included volunteer-based medical students from the Spencer Fox Eccles School of Medicine (SFESOM), current dermatology residents (PGY2-4), and attending dermatology faculty. Each patient was triaged and completed a demographic form provided by the AAD prior to their screening. Dermatology residents and attending physicians conducted free skin cancer screenings, biopsying suspicious lesions when found, with results shared within 10-14 days along with treatment recommendations. Thirty-nine patients were scheduled for screening, with 20 free skin cancer screenings provided. Two biopsies were performed, both showing benign findings with no further treatment needed. The average age of screened patients was 51.5 years, with 35% of patients being Spanish speaking. Additionally, this event provided a first-time learning experience for five medical students. The Fourth Street Clinic’s annual skin cancer screening provides a model for overcoming healthcare access barriers faced by individuals experiencing homelessness. Expanding these services through continued partnerships with the AAD could potentially detect skin cancers earlier, thereby improving patient outcomes and reducing skin cancer-related morbidity. Further efforts are needed to enhance awareness of these screenings.

Copyright: Academy of Health Sciences Educators ©2025

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Enhancing Early Detection: A Community-Based Skin Cancer Screening Initiative at the Fourth Street Clinic by Justin Lyon, Addy Kirkham, Adriene Pavek & Bethany K. H. Lewis, MD, MPH