Date of Award

2022

First Advisor

Jessica Robbins

Second Advisor

Francisca Oyogoa

Abstract

Although skin cancers largely affect people of European descent, they manifest in people of all ancestries. In the United States, when non-White patients present with malignancy in their skin, the cancer is often already in advanced stages and is, therefore, more likely to be fatal. Due to the systemic nature of bias and racism in this country, the issue of late diagnosis of skin cancers in people of color is a multifaceted problem. This thesis explores the social causes behind this issue of late diagnosis of skin cancers and how this dynamic interacts with the biochemical processes that occur in patients of color with skin cancer. I researched the role of ultraviolet (UV) radiations in the pathogenesis of skin cancers in darker-skinned people, the effectiveness of preventative measures in darker skin, and the benefits/harm of high melanin content in the skin. Additionally, I explored the biochemistry of skin cancer including how it manifests in skin of differing melanin concentrations. I discuss how social factors such as access to healthcare, public health awareness, structural and interpersonal racism, misinformation around skin cancer, and doctor expertise in diagnosing/treating diverse populations affect the prognosis for people of color. Finally, I examine how these social factors interact with the biochemical processes by identifying the significant confusion and fatalities that have occurred with their convergence. Structural inequalities in this country determine the priorities in healthcare, research, and education. There is very limited existing research on this topic. Therefore, it is crucial to analyze how the aforementioned social factors apply to the problem of late diagnosis of skin cancers in people of color.

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