33906 Dermatology rural outreach clinics are feasible and decrease barriers to care in patients with skin cancer

Rural populations have higher skin cancer incidence and cancer-related deaths, likely due to lack of access to health care, environmental exposures, and lower socioeconomic status. To address the pressing need for specialty care in rural communities, in 2018, faculty from the University of Utah Department of Dermatology established monthly rural outreach clinics in Moab, Utah (population: 5268) and later Rock Springs, Wyoming (population: 23,319). We performed a retrospective chart review to evaluate the impact of the dermatology rural outreach clinics, focusing on patients diagnosed with biopsy-proven skin cancer. Distance to the nearest dermatologist was an average of 122.6 miles (Moab to Grand Junction, CO) and 171.2 miles (Rock Springs to Park City, UT). With the outreach clinics, this was reduced to an average of 14.1 miles (P < .0001) and 18.1 miles (P < .0001), respectively. Skin cancer was diagnosed in 17% (116/682) of all outreach clinic patients (median age 67.7 years, 54.3% male, 100% White, 67.5% Medicare). 58.8% had a personal history of skin cancer. Of the 188 total skin cancers diagnosed, squamous cell carcinoma was most common (52.1%), followed by basal cell carcinoma (41.5%), malignant melanoma (2.7%), and melanoma in situ (3.7%). Forty-two patients (36.2%) received Mohs surgery referrals; 90.5% were completed at the University of Utah. We did not find significant differences between the Moab and Rock Springs clinics. These results highlight the importance and feasibility of outreach clinics in providing access to dermatologic care, specifically in diagnosing and treating skin cancers in rural populations.