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Mueller AM, Goessinger EV, Cerminara SE, Kostner L, Amaral M, Huber SM, Passweg LP, Moreno LG, Bodenmann D, Kunz M, Levesque MP, Maul JT, Cheng PF, Navarini AA, Maul LV. Educational level-dependent melanoma awareness in a high-risk population in Switzerland. Front Oncol 2023; 13:1174542. [PMID: 37207151 PMCID: PMC10189064 DOI: 10.3389/fonc.2023.1174542] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 04/13/2023] [Indexed: 05/21/2023] Open
Abstract
Introduction The worldwide incidence of melanoma has been increasing rapidly in recent decades with Switzerland having one of the highest rates in Europe. Ultraviolet (UV) radiation is one of the main risk factors for skin cancer. Our objective was to investigate UV protective behavior and melanoma awareness in a high-risk cohort for melanoma. Methods In this prospective monocentric study, we assessed general melanoma awareness and UV protection habits in at-risk patients (≥100 nevi, ≥5 dysplastic nevi, known CDKN2A mutation, and/or positive family history) and melanoma patients using questionnaires. Results Between 01/2021 and 03/ 2022, a total of 269 patients (53.5% at-risk patients, 46.5% melanoma patients) were included. We observed a significant trend toward using a higher sun protection factor (SPF) in melanoma patients compared with at-risk patients (SPF 50+: 48% [n=60] vs. 26% [n=37]; p=0.0016). Those with a college or university degree used a high SPF significantly more often than patients with lower education levels (p=0.0007). However, higher educational levels correlated with increased annual sun exposure (p=0.041). Neither a positive family history for melanoma, nor gender or Fitzpatrick skin type influenced sun protection behavior. An age of ≥ 50 years presented as a significant risk factor for melanoma development with an odd's ratio of 2.32. Study participation resulted in improved sun protection behavior with 51% reporting more frequent sunscreen use after study inclusion. Discussion UV protection remains a critical factor in melanoma prevention. We suggest that melanoma awareness should continue to be raised through public skin cancer prevention campaigns with a particular focus on individuals with low levels of education.
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Affiliation(s)
- Alina Miriam Mueller
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Elisabeth Victoria Goessinger
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Sara Elisa Cerminara
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Lisa Kostner
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Margarida Amaral
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | | | | | | | | | - Michael Kunz
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - Mitchell Paul Levesque
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Julia-Tatjana Maul
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Phil Fang Cheng
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - Alexander Andreas Navarini
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Lara Valeska Maul
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
- *Correspondence: Lara Valeska Maul,
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Photoprotection in Outdoor Sports: A Review of the Literature and Recommendations to Reduce Risk Among Athletes. Dermatol Ther (Heidelb) 2022; 12:329-343. [PMID: 35099755 PMCID: PMC8850489 DOI: 10.1007/s13555-021-00671-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Indexed: 01/04/2023] Open
Abstract
Solar exposure, for long hours and often at peak times with limited shade available, predisposes athletes to episodic sunburn and chronic damage, causing increased risk of precancerous lesions and skin cancer. Environmental factors and training intensity affect risk. Clothing provides good protection, but changing established “uniforms” may not be possible for reasons of practicality, safety, or simply custom. Although physical activity should be encouraged for its physical and mental benefits, risk of skin damage should be minimised. We review existing behaviours, skin cancer risk, and campaigns in the sporting population and highlight key recommendations to help sun protection practices become engrained in sports practice.
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Allen N, Damian DL. Interventions to Increase Sunscreen Use in Adults: A Review of the Literature. HEALTH EDUCATION & BEHAVIOR 2021; 49:415-423. [PMID: 34636262 DOI: 10.1177/10901981211046534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Skin cancers are the most common malignancy in Australia. Regular sunscreen use can reduce the incidence of cutaneous squamous cell carcinomas and actinic keratoses and has been associated with reducing the incidence of basal cell carcinomas and melanomas. However, sunscreen effectiveness is limited by the failure of the population to use it routinely. Interventions that promote the daily application of sunscreen may reduce the morbidity, mortality, and economic burden associated with skin malignancies. We reviewed the literature that examines the effectiveness of interventions to increase routine sunscreen use and found that no one strategy has been shown to be clearly effective in adults and that relatively few studies have aimed to increase routine use in groups at extreme skin cancer risk. Future research should consider how interventions can be best designed and how sunscreen use is measured so that cost-effective, feasible strategies that result in improved sunscreen use in adults can be established.
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Affiliation(s)
- Nicholas Allen
- Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,University of Sydney, Sydney, New South Wales, Australia
| | - Diona L Damian
- Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,University of Sydney, Sydney, New South Wales, Australia.,Melanoma Institute Australia, Sydney, New South Wales, Australia
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4
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Diehl K, Schneider S, Seuffert S, Greinert R, Görig T. Who Are the Nonusers of Sunscreen, and What Are Their Reasons? Development of a New Item Set. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:1045-1053. [PMID: 32144653 PMCID: PMC8520879 DOI: 10.1007/s13187-020-01732-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Sunscreen use is an important aspect of sun protective behavior. Previous studies revealed deficits in sunscreen use. Our aim was to quantify sunscreen use in a nationwide representative study in Germany as well as to develop and test an item battery on reasons for none use of sunscreen. We analyzed data of the National Cancer Aid Monitoring (NCAM; wave 4; n = 3000, aged 14-45). To describe those who only use sunscreen rarely or never, we used chi2 statistics and logistic regression analysis. In addition, we utilized a newly developed item battery on barriers to sunscreen use. Here, we used Cronbach's alpha to investigate reliability. In total, 20.7% reported using sunscreen rarely or never. Infrequent or none use of sunscreen was associated with male sex, immigrant background, none or rare sunbathing in summer, and current or past use of sunbeds. Participants with higher skin cancer risk (e.g., pale skin) were less likely to use sunscreen infrequently or never. The major reasons for not using sunscreen were inconvenience and no perceived need for applying sunscreen. Overall, internal consistency of the item battery on potential barriers to sunscreen use was very good (Cronbach's alpha = 0.865). We found deficits in sunscreen use especially in sunbed users, men, and individuals with immigrant background. Our results give important implications for future prevention and health promotion campaigns on sunscreen use.
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Affiliation(s)
- Katharina Diehl
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Straße 7-11, 68167, Mannheim, Germany.
| | - Sven Schneider
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Straße 7-11, 68167, Mannheim, Germany
| | - Svenja Seuffert
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Straße 7-11, 68167, Mannheim, Germany
| | - Rüdiger Greinert
- Association of Dermatological Prevention (ADP), Hamburg, Germany
- Center of Dermatology, Elbe Clinics, Buxtehude, Germany
| | - Tatiana Görig
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Straße 7-11, 68167, Mannheim, Germany
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5
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Richer V, Kharazmi P, Lee TK, Kalia S, Lui H. Quantifying the visual appearance of sunscreens applied to the skin using indirect computer image colorimetry. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2017; 34:130-136. [PMID: 29080360 DOI: 10.1111/phpp.12361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/18/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is no accepted method to objectively assess the visual appearance of sunscreens on the skin. METHODS We present a method for sunscreen application, digital photography, and computer analysis to quantify the appearance of the skin after sunscreen application. Four sunscreen lotions were applied randomly at densities of 0.5, 1.0, 1.5, and 2.0 mg/cm2 to areas of the back of 29 subjects. Each application site had a matched contralateral control area. High-resolution standardized photographs including a color card were taken after sunscreen application. After color balance correction, CIE L*a*b* color values were extracted from paired sites. Differences in skin appearance attributed to sunscreen were represented by ΔE, which in turn was calculated from the linear Euclidean distance within the L*a*b* color space between the paired sites. RESULTS Sunscreen visibility as measured by median ΔE varied across different products and application densities and ranged between 1.2 and 12.1. The visibility of sunscreens varied according to product SPF, composition (organic vs inorganic), presence of tint, and baseline b* of skin (P < .05 for all). CONCLUSION Standardized sunscreen application followed by digital photography and indirect computer-based colorimetry represents a potential method to objectively quantify visibility of sunscreen on the skin.
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Affiliation(s)
- Vincent Richer
- Department of Dermatology and Skin Science, University of British Columbia & Photomedicine Institute, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Pegah Kharazmi
- Departments of Cancer Control Research Program and Integrative Oncology - Imaging Unit, British Columbia Cancer Agency, Vancouver, BC, Canada.,Department of Electrical and Computer Engineering, Biomedical Engineering Program, University of British Columbia, Vancouver, BC, Canada
| | - Tim K Lee
- Department of Dermatology and Skin Science, University of British Columbia & Photomedicine Institute, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,Departments of Cancer Control Research Program and Integrative Oncology - Imaging Unit, British Columbia Cancer Agency, Vancouver, BC, Canada.,Department of Electrical and Computer Engineering, Biomedical Engineering Program, University of British Columbia, Vancouver, BC, Canada
| | - Sunil Kalia
- Department of Dermatology and Skin Science, University of British Columbia & Photomedicine Institute, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Harvey Lui
- Department of Dermatology and Skin Science, University of British Columbia & Photomedicine Institute, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,Departments of Cancer Control Research Program and Integrative Oncology - Imaging Unit, British Columbia Cancer Agency, Vancouver, BC, Canada
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6
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Kohli I, Shafi R, Isedeh P, Griffith JL, Al-Jamal MS, Silpa-Archa N, Jackson B, Athar M, Kollias N, Elmets CA, Lim HW, Hamzavi IH. The impact of oral Polypodium leucotomos extract on ultraviolet B response: A human clinical study. J Am Acad Dermatol 2017; 77:33-41.e1. [PMID: 28341348 DOI: 10.1016/j.jaad.2017.01.044] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 01/24/2017] [Accepted: 01/24/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND There is a rationale for adding systemic photoprotective agents to the current photoprotection regimen. OBJECTIVE This study was designed to objectively evaluate the molecular and photobiologic effects of oral administration of Polypodium leucotomos extract (PLE). METHODS In all, 22 subjects with Fitzpatrick skin phototype I to III were enrolled. On day 1, subjects were irradiated with visible light, ultraviolet (UV) A1, and UVB (using 308-nm excimer laser). Evaluation was done immediately and 24 hours after irradiation. On days 3 and 4, irradiation and evaluation process was repeated after ingestion of PLE. RESULTS Clinical assessments and colorimetry data showed a decrease in UVB-induced changes in 17 of 22 subjects post-PLE administration; histology findings demonstrated such a decrease in all 22 subjects. LIMITATIONS Only 2 doses of PLE were given. Furthermore, subjects with skin phototypes I to III only were studied. CONCLUSION The results suggest that PLE can potentially be used as an adjunctive agent to lessen the negative photobiologic effects of UVB.
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Affiliation(s)
- Indermeet Kohli
- Multicultural Dermatology Center, Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Rubina Shafi
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Prescilia Isedeh
- Multicultural Dermatology Center, Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - James L Griffith
- Multicultural Dermatology Center, Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Mohammed S Al-Jamal
- Multicultural Dermatology Center, Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Narumol Silpa-Archa
- Multicultural Dermatology Center, Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Bradford Jackson
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Mohammed Athar
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Craig A Elmets
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Henry W Lim
- Multicultural Dermatology Center, Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Iltefat H Hamzavi
- Multicultural Dermatology Center, Department of Dermatology, Henry Ford Hospital, Detroit, Michigan.
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7
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Patient awareness and sun protection behaviour following excision of basal cell carcinoma. Surgeon 2017; 15:12-17. [DOI: 10.1016/j.surge.2015.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 07/08/2015] [Indexed: 11/22/2022]
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8
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Freiman A, Yu J, Loutfi A, Wang B. Impact of Melanoma Diagnosis on Sun-Awareness and Protection: Efficacy of Education Campaigns in a High-Risk Population. J Cutan Med Surg 2016. [DOI: 10.1177/120347540400800501] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Malignant melanoma is a significant cause of morbidity and mortality worldwide. Sun-awareness campaigns increase public knowledge but may not translate into behavioral changes in practice, which is particularly alarming when reported for individuals in high-risk groups. In particular, patients diagnosed with melanoma are at increased risk of developing subsequent primary melanomas compared with the general population. Objectives: The study was undertaken (1) to assess whether patients with known risk factors for developing melanoma had been exposed to preventative campaign messages prior to their diagnosis, (2) to quantify whether the diagnosis of melanoma changed sun-related attitudes and behavior, and (3) to assess the adequacy of sun-related advice given to patients with melanoma, as well as their compliance with the advice. Methods: Using an anonymous questionnaire, 217 patients previously diagnosed with melanoma were interviewed on the source and frequency of received sun-related advice, as well as on their knowledge, attitudes, and behavior toward sun protection before and after the diagnosis. Results: The number of patients who reported receiving sun-related advice after being diagnosed with melanoma increased by 36% (52% pre-vs. 88% postDiagnosis), with advice being given more frequently and more often by a physician (19% pre- vs. 49% postdiagnosis). Furthermore, sun-related attitudes and behavioral practices were positively altered. Yet, patients with known risk factors were not preferentially targeted for advice before their diagnosis. Conclusions: The diagnosis of melanoma leads to increased sunwareness and protection. While dermatologists should continue their efforts to promote and reinforce sun-awareness in patients with melanoma, additional emphasis on preventative targeting of high-risk individuals would be of marked benefit in decreasing the overall incidence of melanoma. Non-dermatologists, such as family physicians, can be key players in this preventative campign, and can be educated to recognize and educate patients at risk, as well as direct them to be followed under dermatology care.
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Affiliation(s)
- Anatoli Freiman
- Division of Dermatology, McGill University Health Centre, 3550 Jeanne-Mance St., Suit 2506, H2X3P7 Montreal, Quebec, Canada
| | - John Yu
- Division of Dermatology, McGill University Health Centre, 3550 Jeanne-Mance St., Suit 2506, H2X3P7 Montreal, Quebec, Canada
| | - Antoine Loutfi
- Department of Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Beatrice Wang
- Division of Dermatology, McGill University Health Centre, 3550 Jeanne-Mance St., Suit 2506, H2X3P7 Montreal, Quebec, Canada
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9
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Szabó C, Ócsai H, Csabai M, Kemény L. A randomised trial to demonstrate the effectiveness of electronic messages on sun protection behaviours. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2015; 149:257-64. [DOI: 10.1016/j.jphotobiol.2015.06.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 06/04/2015] [Accepted: 06/06/2015] [Indexed: 11/26/2022]
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10
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AlGhamdi KM, AlAklabi AS, AlQahtani AZ. Knowledge, attitudes and practices of the general public toward sun exposure and protection: A national survey in Saudi Arabia. Saudi Pharm J 2015; 24:652-657. [PMID: 27829807 PMCID: PMC5094427 DOI: 10.1016/j.jsps.2015.04.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 04/08/2015] [Indexed: 11/12/2022] Open
Abstract
Background: Many international studies have been conducted to assess the knowledge, attitudes and practices (KAP) of the public toward sun exposure and sun-protection measures. However, there are scarce data on these factors from the Middle East. Objectives: This study aimed to explore the KAP of the public toward sun exposure and sun-protection measures among Saudis. Methods: A cross-sectional survey using a specially designed questionnaire was conducted on a stratified random sample of the general population in the five geographical regions of Saudi Arabia (central, eastern, northern, southern, and western). Data were collected between October 2010 and March 2011. Multiple logistic regressions were applied to relate the use of sunscreen and skin cancer awareness with various socio-demographic variables. Results: The questionnaire was distributed to 2900 Saudis. A total of 2622 questionnaires were completed, returned, and included in the data analysis, corresponding to a response rate of 90.4%. The mean (SD) age of respondents was 27.8 ± 9.7 years. Fifty percent (1301/1601) of the respondents were males. Fifty-five percent (1406/2544) were aware of the association between sun exposure and skin cancer. Female, young and student respondents were more likely to be aware of the connection between sun exposure and skin cancer (p < 0.001). Likewise, respondents from the middle social class and those with higher education levels were more likely to be informed (p < 0.02). The prevalence of regular sunscreen use among study participants was only 23.7%, and female and employed respondents were more likely to use sunscreen (p < 0.001). Protective clothes were the most commonly used sun protection measure as reported by more than 90% of our participants. Conclusion: This study has shown that sun awareness and protection are generally inadequate in the Saudi population and suggests the need for health education programs.
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Affiliation(s)
- Khalid M AlGhamdi
- Dermatology Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Vitiligo Research Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Aeed S AlAklabi
- Vitiligo Research Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulla Z AlQahtani
- Vitiligo Research Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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11
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Yan S, Xu F, Yang C, Li F, Fan J, Wang L, Cai M, Zhu J, Kan H, Xu J. Demographic differences in sun protection beliefs and behavior: a community-based study in Shanghai, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:3232-45. [PMID: 25794187 PMCID: PMC4377961 DOI: 10.3390/ijerph120303232] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 03/04/2015] [Accepted: 03/11/2015] [Indexed: 12/17/2022]
Abstract
Objective: We want to know the attitudes and behaviors towards UV protection and we want to analyze the difference between different Chinese demographic groups in this study. Methods: A community-based study was undertaken in Shanghai from October 2009 to January 2010. The participants, ages 20–60 years old, were screened by cluster sampling and were investigated through interviews at their own homes. Personal basic information and questions pertaining to their knowledge and attitudes towards sunlight and sun protective activities were included in the questionnaire. Results: We completed 5964 questionnaires (2794 men and 3170 women). Eighty-six percent of the respondents belonged to Fitzpatrick skin type IV. Knowledge about UV-induced risks was known by more than half of the participants. However, only one-third of the participants thought they needed sun protection in winter and indoors or in vehicles, and 27% of the participants acknowledged tanning was not favorable. The attitudes towards sun exposure varied greatly, showing significant differences based on gender, age, socioeconomic groups and skin type groups (p < 0.05). Fifty-five percent of the participants never use an umbrella under sunlight, only 26.5% of the respondents wear hats, and 21.3% of the participants applied sunscreen. Females and individuals of a younger age and higher education level were more likely to perform sun-protective behaviors than males and those of an older age and lower education level (p < 0.001). Conclusion: There is a deficit in the use of sun protection existing in our surveyed Chinese population, especially in males and lower socioeconomic population, which could allow for planning prevention campaigns and exploring sun-preventive products.
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Affiliation(s)
- Shuxian Yan
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China.
| | - Feng Xu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China.
| | - Chunxue Yang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai 200032, China.
| | - Fei Li
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China.
| | - Jing Fan
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China.
| | - Linggao Wang
- Department of Dermatology, Suzhou First Hospital, Anhui 234000, China.
| | - Minqiang Cai
- Xinjing Community Health Service Center, Shanghai 200335, China.
| | - Jianfeng Zhu
- Xinjing Community Health Service Center, Shanghai 200335, China.
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai 200032, China.
| | - Jinhua Xu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China.
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12
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Sattler U, Thellier S, Sibaud V, Taïeb C, Mery S, Paul C, Meyer N. Factors associated with sun protection compliance: results from a nationwide cross-sectional evaluation of 2215 patients from a dermatological consultation. Br J Dermatol 2014; 170:1327-35. [DOI: 10.1111/bjd.12966] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2014] [Indexed: 11/29/2022]
Affiliation(s)
- U. Sattler
- Laboratoires Dermatologiques Avène; Pierre Fabre Dermo-Cosmétique; Lavaur France
| | - S. Thellier
- Department of Dermatology; Paul Sabatier University and Larrey Hospital; Toulouse France
| | - V. Sibaud
- Laboratoires Dermatologiques Avène; Pierre Fabre Dermo-Cosmétique; Lavaur France
| | - C. Taïeb
- Public Health and Quality of Life; Pierre Fabre SA; Paris France
| | - S. Mery
- Laboratoires Dermatologiques Avène; Pierre Fabre Dermo-Cosmétique; Lavaur France
| | - C. Paul
- Department of Dermatology; Paul Sabatier University and Larrey Hospital; Toulouse France
| | - N. Meyer
- Department of Dermatology; Paul Sabatier University and Larrey Hospital; Toulouse France
- Inserm UMR 1037-CRCT ‘Rho GTPases and Cancer’; Toulouse France
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13
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Diao DY, Lee TK. Sun-protective behaviors in populations at high risk for skin cancer. Psychol Res Behav Manag 2013; 7:9-18. [PMID: 24379732 PMCID: PMC3873203 DOI: 10.2147/prbm.s40457] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Over 3 million new cases of skin cancer are diagnosed in the US annually. Melanoma, a subtype of skin cancer that can be fatal if the disease is not detected and treated at an early stage, is the most common cancer for those aged 25–29 years and the second most common cancer in adolescents and young adults aged 15–29 years. The primary carcinogen for the genesis of skin cancers is ultraviolet light from solar radiation and tanning beds. In spite of massive health campaigns to raise public awareness on ultraviolet radiation, sun-protective practices still fall behind. A plausible explanation is the lack of behavioral change in the populations at risk; in this review article, we examine sun-protective behavior in the four high-risk skin cancer groups: skin cancer survivors, individuals with a family history of melanoma, individuals with physical characteristics associated with skin cancer risk, and organ transplantation patients. Findings in the literature demonstrate that increased knowledge and awareness does not consequently translate into behavioral changes in practice. Behavior can differ as a result of different attitudes and beliefs, depending on the population at risk. Thus, intervention should be tailored to the population targeted. A multidisciplinary health team providing consultation and education is required to influence these much needed changes.
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Affiliation(s)
- Diana Y Diao
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tim K Lee
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada ; Cancer Control Research Program, BC Cancer Agency, Vancouver, British Columbia, Canada
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14
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Wu PA, Stern RS. Topical Tretinoin, Another Failure in the Pursuit of Practical Chemoprevention for Non-Melanoma Skin Cancer. J Invest Dermatol 2012; 132:1532-5. [DOI: 10.1038/jid.2012.136] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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15
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Jung GW, Senthilselvan A, Salopek TG. Likelihood of dermatology patients to inquire about sun protection measures during a regular clinic visit. J Cutan Med Surg 2012; 15:266-74. [PMID: 21962186 DOI: 10.2310/7750.2011.10054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Health information-seeking behavior refers to ways individuals acquire health information. Few studies demonstrate its association with skin cancer. OBJECTIVES To determine the likelihood of patients to inquire about sun protection methods from dermatologists and whether such knowledge will affect their preventive behaviors. METHODS Over a 2-month period, 396 dermatology patients completed a survey assessing their sun awareness knowledge and inquiry about sun protection measures. Features associated with increased skin cancer risk were correlated with patients' inquiry about sun protection information and their future intentions to practice safe sun behavior. RESULTS One in seven patients (13.8%) inquired about sun protection measures. Patients with features known to be associated with increased skin cancer risk infrequently inquired about sun protection methods (4.5-23.8%). Post-physician counseling, patients with previous sun awareness education had a greater intention to use sunscreen routinely (41.4% vs 28.3%, p = .01), avoid the sun (31.2% vs 18.2%, p = .004), and wear sun-protective clothing (32.5% vs 23.2%., p = .05). CONCLUSION Patients' desire for medical information from physicians does not translate efficiently into seeking sun awareness information from dermatologists. Dermatologists should play a greater proactive role in skin cancer prevention through initiation of regular personalized discussions on sun awareness issues.
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Affiliation(s)
- Gordon W Jung
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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Al Robaee AA. Awareness to sun exposure and use of sunscreen by the general population. Bosn J Basic Med Sci 2011; 10:314-8. [PMID: 21108614 DOI: 10.17305/bjbms.2010.2678] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Sun exposure has a pathogenic effect on the development of skin cancer, whose prevalence increases worldwide. Educational programs are carried out to change high risk sun exposure behaviours. The aim of this study was to evaluate the knowledge of Saudi population regarding sun exposure and the risk of skin cancers, as well as to study their sun-protective attitudes and practices. A cross-sectional population-based survey using specially devised questionnaire on a stratified random sample of general population in Qassim Province between January and March 2010. One thousand three hundred and seventy six persons participated in the study. A high sun exposure of more than 10 hours per week was reported by 661 persons (48%). Fifty six percent of respondents were aware of the association between sun exposure and skin cancer but the rate of sun screen use was only 8.3%. Socio-demographic factors more likely to be associated with sunscreen use were: females, higher social class, higher levels of education, type 4 skin and married individuals. This study has indicated a low rate of sunscreen use by our population despite reasonably good knowledge about the hazards of sun exposure. This necessitates the need for health education program. We hope that the results of our study will be used for setting up a sun policy for Saudi general public.
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Thomas M, Rioual E, Adamski H, Roguedas AM, Misery L, Michel M, Chastel F, Schmutz JL, Aubin F, Marguery MC, Meyer N. Physicians involved in the care of patients with high risk of skin cancer should be trained regarding sun protection measures: evidence from a cross sectional study. J Eur Acad Dermatol Venereol 2010; 25:19-23. [DOI: 10.1111/j.1468-3083.2010.03673.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gómez-Moyano E, de Ramón E, Martínez-García S, Gómez R, Crespo-Erchiga V, Crespo A, Ojeda A. Impacto del diagnóstico de melanoma sobre la fotoprotección. ACTAS DERMO-SIFILIOGRAFICAS 2010. [DOI: 10.1016/j.ad.2009.12.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Shedding light on sunscreens and their labels: Testing policies need to match actual use. Am J Prev Med 2010; 38:679-81. [PMID: 20494247 DOI: 10.1016/j.amepre.2010.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 12/15/2009] [Accepted: 02/01/2010] [Indexed: 11/22/2022]
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Jung GW, Senthilselvan A, Salopek TG. Ineffectiveness of sun awareness posters in dermatology clinics. J Eur Acad Dermatol Venereol 2009; 24:697-703. [PMID: 20015181 DOI: 10.1111/j.1468-3083.2009.03491.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although sun awareness posters have been used in doctors' offices and clinics for decades to promote sun protective behaviour, there is no evidence of their usefulness. OBJECTIVES To investigate whether sun awareness posters lead to inquiry of skin cancer and sun protection measures. METHOD Patients considered at risk for skin cancer seen at a dermatology clinic were randomly asked to complete a questionnaire designed to assess the effectiveness of three different sun awareness posters placed in patient rooms. The posters were selected on the basis of their catchy slogan and eye-appealing images, and included those featuring parental interest, sex appeal and informative advice. RESULTS Only half of the patients noticed the posters (50.6%). The poster with sex appeal garnered the most attention (67.8%), followed by the informative poster (49.2%) and the parental interest poster (35.8%) (P < 0.001). Although patients who noticed the sun awareness poster inquired about cutaneous cancers and sun protection practices twice as often as those who did not notice the poster, only one-tenth of such inquiries were attributed to the poster ( approximately 5% of the target population). As reported in the questionnaire, the posters themselves were less effective than the advice of physicians in influencing patient attitudes towards sun protection measures. CONCLUSION Organizations that produce and disseminate posters should consider beyond focus groups when they design their posters and should consider field testing their products to ensure that they are reaching the targeted audience and are having the expected beneficial effect, otherwise their posters are simply decorative.
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Affiliation(s)
- G W Jung
- Division of Dermatology and Cutaneous Sciences, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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Nevins T, Su Y, Doucette S, Kanigsberg N. Incidence of cutaneous malignant melanoma in the Ottawa region: 1996 to 2006. J Cutan Med Surg 2009; 12:276-81. [PMID: 19317949 DOI: 10.2310/7750.2008.07075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The incidence rates of invasive primary cutaneous malignant melanoma in Canada have shown a gradual tapering in recent years, after decades of increases. This trend suggests that the incidence of melanoma in Canada is stabilizing; however, knowledge of the recent trend for both in situ and invasive tumors was lacking. OBJECTIVE The purpose of this study was to examine the temporal trend of both in situ and invasive melanoma within the Ottawa region over a 10-year period. METHODS The histopathology of cutaneous melanomas diagnosed in the Ottawa region was obtained for the years 1996, 2001, and 2006 from the main diagnostic centers servicing the area; however, not all melanomas have been accounted for. All rates are expressed per 100,000 population per year. RESULTS Melanoma incidence decreased between 1996 and 2001 (-3.83) and increased between 2001 and 2006 (+7.46; p < or = .05). This increase is mainly attributable to in situ melanoma (+5.49; p < or = .05). There has been no statistically significant change in invasive melanoma. CONCLUSIONS Invasive melanoma incidence in the Ottawa region remained stable, whereas in situ melanoma incidence increased.
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Affiliation(s)
- Tara Nevins
- Faculty of Medicine, University of Ottawa, ON
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22
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Aspinwall LG, Leaf SL, Kohlmann W, Dola ER, Leachman SA. Patterns of photoprotection following CDKN2A/p16 genetic test reporting and counseling. J Am Acad Dermatol 2009; 60:745-57. [PMID: 19278751 DOI: 10.1016/j.jaad.2008.12.034] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2008] [Revised: 12/12/2008] [Accepted: 12/18/2008] [Indexed: 11/24/2022]
Abstract
BACKGROUND The impact of melanoma genetic testing and counseling on photoprotective behaviors is unknown. OBJECTIVE To determine if genetic testing and counseling alter compliance with photoprotection recommendations. METHODS Reported use of sunscreen, protective clothing, and sun avoidance by 59 members of CDKN2A/p16-mutation positive pedigrees was assessed as a function of mutation status and melanoma history, before, immediately after, and 1 month following test reporting. RESULTS Intentions to practice all photoprotective behaviors increased in all participant groups (P < .0001). At 1 month, 33% of participants reported the adoption of a new photoprotective behavior. Subpopulation analyses identified different patterns of change in photoprotection relative to baseline (P < .005), with no net decline in any group. LIMITATIONS This initial study of CDKN2A/p16 families is small and awaits replication in a larger sample. CONCLUSION Melanoma genetic testing and counseling enhanced intentions to implement photoprotective strategies and did not result in reduced compliance in the CDKN2A/p16-subpopulation.
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Affiliation(s)
- Lisa G Aspinwall
- Department of Psychology, University of Utah, Salt Lake City, Utah, USA
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23
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Meyer N, Pruvost-Balland C, Bourdon-Lanoy E, Maubec E, Avri MF. Awareness, knowledge and attitudes towards sun protection among skin cancer-treated patients in France. J Eur Acad Dermatol Venereol 2007; 21:520-5. [PMID: 17373981 DOI: 10.1111/j.1468-3083.2006.02019.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The incidence of skin cancer has risen over the past years, owing to increased exposure to ultraviolet radiation. Sun protection measures include avoiding exposure to the sun, using covering clothing and applying sunscreen. We evaluated the knowledge and compliance with advices about sun protection in a population of patients who had presented skin tumour(s). SUBJECTS AND METHODS A 30 question self-reporting questionnaire evaluating sun protective behaviour was distributed to 217 consecutive skin cancer-treated patients and completed by 198 of them. RESULTS 72% of the responders had presented a melanoma, and 26% of them had presented only non-melanoma skin cancer. The present survey shows that patients who have had a skin cancer were aware of the cancer related risk of sunlight since 98% of the responders knew that ultraviolet radiations can include skin cancer. These patients did also take sun-protective measures because 73% of them had worn covering clothes when in the sun and 59% of them avoided outdoor activities during the midday hours. CONCLUSION These results suggest that, after diagnosis of a skin cancer, patients limited their sun exposure; and wear protective clothing. However, sun-protection measures did not seem to be completely adequate. An evaluation of the various barriers to sun safety might be a key to understanding the sub-optimal sun protection.
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Affiliation(s)
- N Meyer
- Institut Gustave Roussy, Service de Dermatologie, Villejuif, France.
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Solky BA, Phillips PK, Christenson LJ, Weaver AL, Roenigk RK, Otley CC. Patient preferences for facial sunscreens: A split-face, randomized, blinded trial. J Am Acad Dermatol 2007; 57:67-72. [PMID: 17499389 DOI: 10.1016/j.jaad.2007.04.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2006] [Revised: 03/01/2007] [Accepted: 04/05/2007] [Indexed: 11/23/2022]
Abstract
BACKGROUND Sunscreen use is a widely accepted method of primary prevention against skin cancer, sunburn, and photoaging. However, many people do not routinely apply sunscreen because they find application objectionable. OBJECTIVE To determine which types of sunscreen subjects are willing to use on more than one occasion. METHODS A split-face, randomized, blinded trial of commercially available sunscreens was performed among 139 community members in Rochester, Minnesota. RESULTS Subjects were significantly more likely to indicate that they would use alcohol-based spray sunscreen again than two of the seven sunscreens assessed (P < .05). This sunscreen was endorsed as being less greasy, less likely to leave a film, and less likely to leave them feeling hot and sweaty than at least two of the other sunscreens. LIMITATIONS Only a representative selection of commonly available sunscreens was tested. CONCLUSION An alcohol-based spray formulation of sunscreen was rated more favorable. Recommendations to use alcohol-based spray sunscreens may increase patient compliance.
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Lee TK, Brazier ASA, Shoveller JA, Gallagher RP. Sun-related behavior after a diagnosis of cutaneous malignant melanoma. Melanoma Res 2007; 17:51-5. [PMID: 17235242 DOI: 10.1097/cmr.0b013e3280112b98] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cutaneous malignant melanoma is a significant public health problem in Western countries, and the probability that patients with one melanoma will develop a second one is high. This study is an attempt to assess and understand sun-related behavior in patients subsequent to a melanoma diagnosis. We recruited 35 melanoma patients diagnosed in 2001 or 2002, who resided in the Greater Vancouver Regional District of British Columbia, Canada, and 35 controls frequency matched by broad age-group, sex, ethnicity, and area of residence to patients. All participants were interviewed over the telephone in the autumn of 2003 to ascertain their outdoor activities for the previous summer months (June-August) of 2003, along with their clothing preferences, sunscreen use, sunburn frequency, and knowledge and attitudes regarding sun exposure and tanning. Patients were less involved in outdoor recreational activities than controls (mean monthly hours 23.0 vs. 31.0, P=0.023). In addition, patients protected themselves from sun exposure using clothing and sunscreen more often than controls. However, the data also revealed that patients still engaged in outdoor activities to a substantial degree, often without sun protection. Furthermore, 27% still had a positive or neutral attitude toward tanning, even after melanoma diagnosis. The continuing presence of unprotected episodes of summer sun exposure in patients with melanoma, coupled with sunburn prevalence similar to normal controls, suggests that better education and behavior modification programs are needed for patients with melanoma. The results may indicate the need for more emphasis on post-treatment counseling by physicians.
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Affiliation(s)
- Tim K Lee
- Cancer Control Research Program, BC Cancer Agency, Vancouver, British Columbia, Canada.
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Peacey V, Steptoe A, Sanderman R, Wardle J. Ten-year changes in sun protection behaviors and beliefs of young adults in 13 European countries. Prev Med 2006; 43:460-5. [PMID: 16949656 DOI: 10.1016/j.ypmed.2006.07.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2005] [Revised: 07/17/2006] [Accepted: 07/17/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Sun protection behaviors are important to the prevention of skin cancers, but little is known about changes over time in attitudes and behavior. METHODS Cross-sectional surveys were carried out among university students in thirteen European countries in 1990 (n = 10,241) and 2000 (n = 10,161). Sun protection behavior and beliefs about the importance of sunscreen use for health were measured. RESULTS There was little change in the proportion of men and women who sunbathed, but use of sun protection increased over the 10-year interval from 52% to 63% in men and 80% to 87% in women. There was wide variation in sun protection use and strength of health beliefs between countries. The association between strength of beliefs and behavior was more marked in 2000 than 1990. Sun protection behavior was positively associated with the socioeconomic background of participants. CONCLUSION The use of sunscreen increased among educated young Europeans from several countries over the 1990s, but important sex differences remain. Awareness of the risk to health of unprotected sunbathing is high, but there is scope of strengthening attitudes to sunscreen use.
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Affiliation(s)
- Victoria Peacey
- Cancer Research UK Health Behaviour Unit, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK
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Brown TT, Quain RD, Troxel AB, Gelfand JM. The epidemiology of sunburn in the US population in 2003. J Am Acad Dermatol 2006; 55:577-83. [PMID: 17010735 DOI: 10.1016/j.jaad.2006.05.029] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2005] [Revised: 05/05/2006] [Accepted: 05/20/2006] [Indexed: 11/19/2022]
Abstract
BACKGROUND Sunburn is a major preventable risk factor for skin cancer. OBJECTIVE We investigated risk factors for sunburn in the United States based on the 2003 Behavioral Risk Factor Surveillance System. DESIGN AND METHODS A random sample of 207,776 respondents provided data for the population-based survey. The main outcome measure was any report of sunburn within the previous 12 months. RESULTS Overall, 39% of respondents had at least one sunburn. The strongest factors associated with sunburn were age and socioeconomic factors. Sunburn prevalence was greatest in respondents 18 to 24 years old (61%). This group was more likely to have a sunburn than respondents 45 to 54 years of age (odds ratio [OR] = 2.76). Higher income and higher levels of education were positively associated with sunburn (OR 1.67 and 1.63, respectively). Individuals reporting recent binge drinking had a higher prevalence of sunburn (OR = 1.33). LIMITATIONS The Behavioral Risk Factor Surveillance System does not include data on skin type or sun protection behavior; therefore the impact of these factors was not assessed. CONCLUSION Sunburn occurs at a very high rate in the United States.
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Affiliation(s)
- Tamu T Brown
- University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
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Geller AC, Halpern AC. The benefits of skin cancer prevention counseling for parents and children. J Am Acad Dermatol 2006; 55:506-8. [PMID: 16908359 DOI: 10.1016/j.jaad.2006.05.059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2006] [Revised: 05/26/2006] [Accepted: 05/30/2006] [Indexed: 10/24/2022]
Affiliation(s)
- Alan C Geller
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts 02118, USA.
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Abstract
OBJECTIVES To evaluate the use, knowledge, and perceptions of sun-protective behavior (SPB), among young athletes in Southern California. DESIGN Cross-sectional survey, assessing various measures of SPB, sun exposure, attitudes, and knowledge. SETTING AND PARTICIPANTS A total of 1006 students from 2 public high schools and 1 public university in the Los Angeles area volunteered. Athlete volunteers were recruited during sports preparticipation examinations. Nonathlete controls were recruited from physical education classes (high school) and from an introductory lecture class (university). MAIN OUTCOME MEASURES Use of SPB during sports and nonsports activities, sun exposure, sun-protection knowledge, and attitudes. Results from athletes were compared with those from controls at each site. RESULTS Overall rates of SPB were low. During nonsports activities, university athletes had higher rates of sunscreen (37.7% vs. 32.3%, P = 0.03) and hat use (34.7% vs. 17%, P < 0.001) than did controls. However, university athletes had lower rates of use of long shirts (27.9% vs. 39.8%, P < 0.001), long pants (38.8% vs. 63%, P < 0.002), and had higher total sun exposure (16.1 vs. 10.1 h/wk, P < 0.001). Similar results were seen among the high-school subjects. Despite having good knowledge of the potential dangers of ultraviolet radiation exposure, approximately 1 in 5 subjects overall had experienced a blistering sunburn within the past year. CONCLUSIONS Young athletes in the Los Angeles area reported low rates of SPB, high levels of ultraviolet radiation exposure, and high rates of sunburns, despite knowing the risks of sun exposure. Specific educational and behavioral interventions should be directed toward improving SPB in this high-risk group.
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Affiliation(s)
- Philip H Cohen
- Rutgers University Sports Medicine, Picataway, NJ 08854, USA.
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Abstract
The objective of this article was to review patient adherence to topical medications and its relationship to health outcomes in dermatologic disease. To this end, MEDLINE searches from January 1966 through June 2006 and EMBASE searches from January 1974 through June 2006 were conducted. Relevant human efficacy studies, including randomized controlled trials, observational studies, and case-control studies, were selected on the basis of the key words 'compliance,' 'adherence,' 'pharmionics,' 'topical,' 'medication,' or 'dermatology.' Studies were included and reviewed on the basis of their experimental design, controls, and statistical analysis. Analysis revealed that suboptimal adherence to topical medications is a common cause of minimal response or lack of response to drugs and is linked with poor dermatologic outcomes in diseases such as psoriasis, atopic dermatitis, and acne. It is concluded that non-adherence to topical medications is as common as non-adherence to oral medications, and its relationship to poor health outcomes is clear. Several barriers to topical medication adherence and predictors of non-adherence are similar to those for oral medications, while other barriers and predictors are unique to topical medications and the nature of dermatologic disease. Further studies of effective interventions to increase adherence are necessary to improve health outcomes in dermatology.
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Affiliation(s)
- Ivy A Lee
- Department of Dermatology, School of Medicine, University of California, San Francisco, California 94143-0989, USA
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Freiman A, Yu J, Loutfi A, Wang B. Impact of Melanoma Diagnosis on Sun-Awareness and Protection: Efficacy of Education Campaigns in a High-Risk Population. J Cutan Med Surg 2005; 8:303-9. [PMID: 15868284 DOI: 10.1007/s10227-005-0009-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Malignant melanoma is a significant cause of morbidity and mortality worldwide. Sun-awareness campaigns increase public knowledge but may not translate into behavioral changes in practice, which is particularly alarming when reported for individuals in high-risk groups. In particular, patients diagnosed with melanoma are at increased risk of developing subsequent primary melanomas compared with the general population. OBJECTIVES The study was undertaken (1) to assess whether patients with known risk factors for developing melanoma had been exposed to preventative campaign messages prior to their diagnosis, (2) to quantify whether the diagnosis of melanoma changed sun-related attitudes and behavior, and (3) to assess the adequacy of sun-related advice given to patients with melanoma, as well as their compliance with the advice. METHODS Using an anonymous questionnaire, 217 patients previously diagnosed with melanoma were interviewed on the source and frequency of received sun-related advice, as well as on their knowledge, attitudes, and behavior toward sun protection before and after the diagnosis. RESULTS The number of patients who reported receiving sun-related advice after being diagnosed with melanoma increased by 36% (52% pre-vs. 88% postDiagnosis), with advice being given more frequently and more often by a physician (19% pre- vs. 49% postdiagnosis). Furthermore, sun-related attitudes and behavioral practices were positively altered. Yet, patients with known risk factors were not preferentially targeted for advice before their diagnosis. CONCLUSIONS The diagnosis of melanoma leads to increased sun-awareness and protection. While dermatologists should continue their efforts to promote and reinforce sun-awareness in patients with melanoma, additional emphasis on preventative targeting of high-risk individuals would be of marked benefit in decreasing the overall incidence of melanoma. Non-dermatologists, such as family physicians, can be key players in this preventative campaign, and can be educated to recognize and educate patients at risk, as well as direct them to be followed under dermatology care.
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Affiliation(s)
- Anatoli Freiman
- Division of Dermatology, McGill University Health Centre, 3550 Jeanne-Mance St., H2X3P7 Montreal, Quebec, Canada.
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Abstract
The incidence, morbidity and mortality of skin cancer are markedly increased in organ transplant recipients. Efforts aimed at reducing sun exposure through sun avoidance, sunscreens and sun-protective clothing are the most effective means to reduce the risk of skin cancer. We evaluated the sun-protective behaviors of 205 transplant recipients. Twenty-three percent of transplant patients continued to seek a tan. Thirty percent of patients did not use sunscreens, and of those patients who did, less than 5% were committed to using them daily. Thirty-seven percent of patients frequently wore hats and 39% of patients frequently wore additional clothing to block the sun. When data were stratified according to patient age, gender or skin phototype, we identified preferences for specific sun-protective methods. These data strongly suggest that many transplant recipients do not use adequate sun protection. Further study of strategies to encourage the use of sun protection among transplant patients is needed to reduce the incidence of skin cancer.
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Affiliation(s)
- Jeffrey C H Donovan
- Division of Dermatology, Toronto Western Hospital, University Health Network, University of Toronto, 399 Bathurst St, Toronto, ON, Canada
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