Abstract B057: Race, skin tone complexion, and melanoma risk perception: Mediating roles of knowledge, attitudes and behaviors

Abstract Melanoma is the most commonly diagnosed skin cancer in the United States, responsible for 100,000 new cases in 2025. Melanoma mortality disproportionately impacts people of lower socioeconomic and people of color, especially Hispanic and Black individuals. Melanoma diagnosis and awareness is often lower in these groups, leading to worse outcomes and advanced disease. Melanoma includes various subtypes, with acral lentiginous melanoma (ALM) being the most frequently diagnosed among Hispanic and Black populations; ALM arises on sites not directly exposed to the sun, such as the palms, soles, and nails, distinguishing it from the more common cutaneous melanoma. Since 2014, melanoma mortality has declined in non-Hispanic Whites but not in Hispanic, Black, or rural groups. Delayed diagnosis in Black and Hispanic populations may stem from the misconception that darker skin protects against melanoma, alongside limited lesion recognition and cultural beliefs reducing prevention efforts. Our study investigates the complex interplay between race, skin-tone complexion, and melanoma risk perception, examining how knowledge, attitudes, and behaviors influence this relationship. By elucidating how deeply ingrained beliefs about identity shape melanoma awareness, this work underscores the urgent need for culturally tailored education and targeted interventions to address and reduce persistent health disparities. We conducted a cross-sectional survey of approximately 100 self-identified Black and Hispanic adults in Kentucky, using anonymous online and paper surveys. Primary exposures included race/ethnicity and skin tone complexion. Outcomes were perceived melanoma risk, sun protection behaviors, melanoma knowledge, healthcare engagement, and personal/family history of skin cancer. Mediators included knowledge (melanoma awareness and screening beliefs), attitudes (cancer worry and perceived susceptibility), and behaviors (sun protection and skin checks). Data were analyzed using descriptive statistics and group comparisons in SPSS. A significant association was found between ethnicity and skin cancer screening (p .001), with 79.4% of screened individuals identifying as Hispanic or Latino. Despite 58% expressing concern about skin cancer, only one participant reported performing self-skin checks, revealing a large gap between concern and action. Over two-thirds (67.1%) felt treated with less respect, and 57.1% attributed this to skin color, suggesting perceived discrimination may affect care-seeking. Participants with deep brown complexions (shades 430–498) were significantly more likely to spend time in the sun (53.4% vs. 16.7%, p = .022) compared to those with fair-to-golden skin (shades 100–250). Although not statistically significant, those with lighter complexions were more likely to have searched for sun protection information (91.7% vs. 56.5% and 75.0%, p = .063). These findings emphasize the need for culturally and complexion-sensitive education that bridges the gap between awareness, perceived risk, and preventive behaviors Citation Format: Gabriella Beharry B.S., Valeria Miranda B.S., Cindy Lin B.S., Luis Comas Marrero B.S., Dr. Sydney Howard DrPH, MS, Dr. Justin Moore Ph.D.. Race, skin tone complexion, and melanoma risk perception: Mediating roles of knowledge, attitudes and behaviors abstract. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B057.