Incidence rates of skins cancers, including melanoma, and squamous and basal cell carcinoma are on the rise among Hispanic/Latinos (H/L). Primary and secondary prevention can reduce the burden of morbidity and mortality due to these skin cancers. Inherited variation at the melanocortin-1 receptor (MC1R) locus is a robust marker of skin cancer risk, and disease risk associated with MC1R variants is often stronger in individuals without traditional clinical risk phenotypes, for example individuals with dark hair color, scant freckles and who do not easily burn. To determine whether knowledge and feedback of MC1R genotype can play a role in the promotion of behaviors linked to risk reduction and early detection of skin cancers, we will randomized 400 H/L participants identified from general internal medicine clinics in Ponce, Puerto Rico and 400 H/L participants identified from family practice clinics in Tampa, Florida to receive mailed health education materials containing either i) generic information about skin cancer risk, risk reduction and early detection (control arm) or ii) precision genetic information about skin cancer risk, risk reduction and early detection anchored in results from MC1R genotyping (intervention arm). We hypothesize that individuals who carry high risk MC1R variants and who receive precision information containing their MC1R genotype information will show improvement in skin cancer risk reduction and early detection behaviors over the course of 9 months. Prevention and early detection behaviors will be measured at baseline and again at 3 and 9 months. Our main outcome measures of interest are number of hours spent in the midday sun (primary prevention outcome) and completion of a skin examination (secondary prevention outcome). We also will assess whether health beliefs, cancer-related distress and worry, knowledge, fatalism, or familism mediate behavior change. In an exploratory fashion, we also will assess the impact of receipt of MC1R genotype on changes in behaviors among children of study participants. Here we will focus on number of sunburns in children as our main outcome of interest. The results of this project will help inform whether genetic screening targeted to the general H/L population of can positively influence risk behaviors associated with skin cancer.
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