ORIGINAL RESEARCH Improvement of Early Detection of Cutaneous Malignancies and Reduction of Healthcare Costs at Farmers' Markets and a Church in Oklahoma City: A Pilot and Cross-Sectional Study by ANUJ KUNADIA, MD; VICTORIA BRITO, BA; JACQUELINE OH, BA; ALEXANDRA SMITH, BS; HANXIA LI, BS, MS; DANIEL ZHAO, PhD; and JEFFREY MCBRIDE, MD, PhD Drs. Kunadia and McBride are with the University of Oklahoma Mark Allen Everett Department of Dermatology in Oklahoma City, Oklahoma. Ms. Brito and Ms. Oh are with the University of Oklahoma College of Medicine in Oklahoma City, Oklahoma. Ms. Smith is with Oklahoma State University College of Osteopathic Medicine in Tahlequah, Oklahoma. Mr. Li and Dr. Zhao are with the Department of Biostatistics and Epidemiology at the University of Oklahoma Health Sciences Center in Oklahoma City, Oklahoma. J Clin Aesthet Dermatol. 2025;18(10):55–58. OBJECTIVE: The authors sought to evaluate the feasibility, educational outcomes, and cost-savings of free dermatologic screenings at local farmers' markets and a church in Oklahoma City, Oklahoma. METHODS: We piloted six free skin cancer screenings at farmers' markets and a church in Oklahoma. Exposed areas were examined by dermatology residents under supervision of a board-certified dermatologist. Suspicious lesions were referred. Pre-and postscreening surveys assessed knowledge, sunscreen use, and barriers to care. Demographics and ZIP codes were collected. Follow-up was conducted at 6 months. We estimated cost savings per screening using published visit costs and Internal Revenue Service (IRS) mileage rates. Statistical analysis included paired t -tests, analysis of variance (ANOVA), and chi-square tests ( p <0.05). RESULTS: Among 411 adults, 40 participants (9.7%) had notable lesions, including 7 confirmed basal cell carcinomas and 23 actinic keratoses. Awareness of risk-reducing practices and lesion recognition increased significantly postcounseling (both p <0.0001). The most reported barrier to dermatology was lack of perceived need. Estimated cost savings per participant was $156.70, totaling $64,403.70 across all participants. LIMITATIONS: Limitations include reliance on self-reported survey data, incomplete follow-up among referred participants, and lack of histopathologic confirmation for all findings. CONCLUSION: This study shows the feasibility and cost-effectiveness of free skin screenings when paired with local farmers' markets, which often provide complimentary spaces for nonprofit organizations. These low-cost models may enhance earlier detection and awareness in communities with limited access. KEYWORDS: Skin cancer screening, underserved populations, community health outreach, health disparities, preventive dermatology, cost-effective screening kin cancer is the most common malignancy in the United States (US), yet access to dermatologic care is not equally distributed across all communities. Patients in underserved areas, particularly those of minority racial or ethnic backgrounds, experience disproportionately worse outcomes due to delayed diagnosis and limited preventive care. Despite national awareness campaigns, persistent disparities exist in both sun protection behaviors and familiarity with warning signs. 1,2 Community-based skin screenings offer a promising avenue to bridge this gap, particularly when integrated into trusted local spaces, but data on effectiveness and cost-benefit analysis in nonclinical settings are limited. We piloted six free skin screening programs conducted at local farmers' markets and a church in Oklahoma City, Oklahoma to assess feasibility, earlier detection outcomes, educational impact, and cost-effectiveness across community demographics. From June to October 2024 we conducted five free skin cancer screening events at a local farmers' market serving a diverse urban population and one at a church serving a predominantly minority population. Across FUNDING: No funding was provided for this article. DISCLOSURES: The authors have no conflicts of interest relevant to the content of this article. CORRESPONDENCE: Anuj Kunadia, MD; Email: anuj-kunadia@ouhsc.edu S METHODS six events, 411 adults participated. Dermatology residents, under the supervision of a board-certified dermatologist, conducted focused skin exams limited to exposed areas. Participants with concerning findings were referred to dermatology clinics for follow-up. Six months after the event, follow-up calls were made to assess whether referred individuals had pursued further evaluation. Some participants could not be reached, declined follow-up, or had not yet completed their referral visits. Participants completed surveys before and after screening to assess awareness of risk-minimizing practices such as sun safety practices, ability to recognize concerning lesions, sunscreen use, and perceived barriers to dermatologic care. Demographic information, including race, gender, and ZIP code, was collected. Venue resources, including tents, chairs, and tables, were utilized at no cost. Incentives included donated skin care products. Statistical analyses were performed using paired t -tests for pre-and postcounseling comparisons, analysis of variance (ANOVA) to compare awareness across racial groups, and chi-square testing for categorical variables. Statistical significance was defined as p <0.05. JCAD JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY October 2025 • Volume 18 • Number 10 55
Journal of Clinical and Aesthetic Dermatology October 2025: Page 55
