. Author manuscript; available in PMC: 2020 Jun 1.

Published in final edited form as: J Am Acad Dermatol. 2017 Dec 30;78(6):1185–1192. doi: 10.1016/j.jaad.2017.11.062

Table II.

Studies of skin cancer and risk factors among military personnel

Study	Study population	Design	Study size (N)	Major findings	Reported limitations
Ramani et al (1993)⁹	World War II veterans who served in the Pacific or Europe and were referred for Mohs micrographic surgery at the University of Southern California	Retrospective chart review	370	66% of patients with BCC and 68% of patients with SCC previously stationed in the Pacific	N/A
Henning et al (2010)²⁹	Patients with dermatology visits at 86th Combat Support Hospital in Ibn Sina, Iraq, between January 15, 2008 and July 15, 2008	Retrospective chart review	2696	8% of total visits were for skin cancer: BCC (n = 70), SCC (n = 68), mycosis fungoides (n = 1), bowenoid papulosis (n = 1), melanoma (n = 9)	- Referral bias may result in underestimation of skin cancer incidence - Diagnoses not subject to inter observer correlation - Increased surveillance and average patient age may result in increased skin cancer estimates
Parker et al (2015)³¹	Air Force Maintenance squadrons at Travis Air Force Base in California (AFMT)	Cross-sectional survey	356	- 67% of respondents’ careers involved direct sun exposure - 88% were aware that sunscreen can prevent skin cancer, but less than 11% used it most of the time	- Unable to compare UV exposure duration with that in other studies - Conclusions based on survey responses - Limited generalizability
Powers et al (2015)¹⁰	Veterans returning from OEF/OIF missions seen at Nashville Tennessee Valley Post Deployment Clinic	Cross-sectional survey	212	- 77% spent ≥4 h/d working in bright sun - <30% had routine access to sunscreen - 23% said that US military made them very aware of skin cancer risks	- Recall bias - Regional study limited to mostly 1 military branch - 80% of responses involved recall after a ≥1-y period
McGrath et al (2016)³⁰	Veterans with skin cancer treatment at Audie Murphy Veterans Hospital and University of Texas Health Science Center-San Antonio	Cross-sectional survey	41	- Participants reported inadequate education about skin cancer - Participants requested predeployment education and increased protective equipment availability	- Sample size - Qualitative report of responses

AFMT, Airway facilities management team; BCC, basal cell carcinoma; N/A, not available; OEF, Operation Enduring Freedom; OIF, Operation Iraqi Freedom; SCC, squamous cell carcinoma; UV, ultraviolet.