# Skin Cancer in Residential Care Facilities: A Scoping Review of Risk, Diagnosis, Psychosocial Impact, and Management

## TL;DR

This review highlights the high prevalence of skin cancer in nursing home residents and the challenges in diagnosis and management due to limited care access and unique risk factors.

## Contribution

The study maps current evidence on skin cancer in nursing home residents, identifying gaps in diagnosis, prevention, and management.

## Key findings

- Skin cancer prevalence among nursing home residents ranges from 15 to 40%.
- Barriers include limited dermatologic care access and lack of standardized screening.
- Psychosocial factors like distress and reduced quality of life are significant in this population.

## Abstract

The older adult population is rising, resulting in a larger number of adults residing in nursing homes. Skin cancer is most commonly diagnosed in older adults. Yet, these individuals often face limited access to advanced dermatologic care, in addition to unique risk factors such as inadequate sun protection and reduced mobility. This review aims to map the current evidence on skin cancer risk and diagnosis, as well as prevention strategies among older adults residing in nursing homes. A search was conducted on PubMed using the algorithm: ((nursing home) OR (assisted living) OR (elderly living facility)) AND (skin cancer), where 269 papers were retrieved. Inclusion criteria included full-text primary sources published from 2015 to 2025. Exclusion criteria included duplicates, reviews, animal studies, and studies not about skin cancer in nursing home settings. Title review narrowed the search to 38 papers. Following abstract screening, five final papers were included. A comprehensive review of the included studies demonstrated that there is a high prevalence of skin cancer among nursing home residents. There were a total of 4785 participants among the five papers, and skin cancer prevalence varied from 15 to 40% across studies. Nearly half of the diagnosed cases were basal cell carcinoma, a quarter were squamous cell carcinoma, and the final quarter was unspecified. Factors that contribute to the prevalence of skin cancer include age, immobility, incontinence, and a lack of appropriate sun protection. Additionally, systematic barriers, such as limited access to specialized dermatologic services, the absence of standardized screening practices, and limited staff training, increase the risk of delayed diagnosis and inadequate management of skin cancer in nursing home patients. Skin cancer in older adults, particularly those in long-term care, is also shaped by psychosocial challenges such as personality traits that influence distress, reduced quality of life, and delays in seeking treatment, highlighting the importance of early detection and supportive care interventions. To improve outcomes for this vulnerable population, there is a need to implement routine skin assessments, strengthen staff education on dermatologic care, and increase timely specialist referrals for proper detection and treatment of skin cancer.