'Being a farmer, I mostly always think there is something more important to do': A mixed methods analysis of the skin cancer detection practices of Australian farmers

Chloe M E Fletcher; Camilla Trenerry; Carlene Wilson; Kate M Gunn

doi:10.1002/hpja.796

'Being a farmer, I mostly always think there is something more important to do': A mixed methods analysis of the skin cancer detection practices of Australian farmers

Health Promot J Austr. 2023 Aug 23. doi: 10.1002/hpja.796. Online ahead of print.

Authors

Chloe M E Fletcher¹, Camilla Trenerry^{2

3}, Carlene Wilson^{4

5

6}, Kate M Gunn^{1

2}

Affiliations

¹ Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.
² Freemasons Foundation Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, South Australia, Australia.
³ School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia.
⁴ Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia.
⁵ Olivia Newton John Cancer Wellness Research Centre, Austin Health, Melbourne, Victoria, Australia.
⁶ School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.

PMID: 37611617
DOI: 10.1002/hpja.796

Abstract

Issue addressed: Farmers experience skin cancer and die from melanoma at significantly higher rates than the general Australian population. This study examined Australian farmers' engagement with self-skin examinations (SSE), participation in clinical skin examinations (CSE) by a health professional, and self-reported barriers to engagement with these important skin cancer detection practices.

Methods: A cross-sectional, mixed-methods design was used. Australian farmers were recruited through an industry-based organisation representing livestock farmers. Farmers (N = 498; 22-89 years; 83.1% male) responded to a paper-based survey that included closed- and open-ended questions.

Results: Farmers reported engagement with self-conducted SSE and routine CSE that was comparable to findings in the general population, but 29.4% of farmers reported that they had not sought a CSE as soon as possible after noticing changes to their skin. Farmers reported a range of barriers to SSE, including physical difficulties examining their skin, difficulties identifying changes in their skin, forgetfulness, and lack of motivation. Barriers to CSE included accessibility, cost, difficulties finding the right doctor, and avoidance and complacency.

Conclusions: There is a need to make clinical skin cancer detection more accessible to farmers, in addition to promoting self-skin examination and help-seeking behaviours within this at risk population. SO WHAT?: Novel approaches are needed to address systemic barriers faced by Australian farmers. These may include the use of teledermatology or artificial intelligence to assist with CSE. Remote training delivery methods may be also utilised to teach SSE skills to farmers who may be otherwise unable to access such opportunities.

Keywords: agriculture; health behaviour; occupational medicine; physical examination; rural health; self-examination; skin neoplasms.