Awareness of Skin Cancer, Prevention, and Early Detection among Turkish University Students

Awareness and knowledge of sun exposure and use of sunscreen among adults in Aseer region, Saudi Arabia

Background

Excessive sun exposure and inadequate sunscreen use can lead to skin cancer and other harmful effects on the skin, eyes, and immune system.

Purpose

This observational cross-sectional study aimed to assess awareness and knowledge of sun exposure and sunscreen use among adults in the Aseer region, Saudi Arabia. This study also focused on evaluating the risks of skin cancer and participants' sun-protective attitudes and practices.

Methods

A population-based cross-sectional study was conducted among adults in the Aseer region, Saudi Arabia. Data were collected using a questionnaire from November 2022 to January 2023 that assessed participants' knowledge, practices, and beliefs regarding sun exposure and sunscreen use. A total of 400 participants were selected for the study. Approval for the study was granted by the Local Research Ethics Committee of the University of Bisha, Saudi Arabia.

Results

The results revealed that (59.8 %) of the participants were female, while (40.3 %) were male. Regarding age, the majority fell within the 26-35 age range (37.5 %), with (16.0 %) of participants using sunscreen regularly, with a total of (74.0 %) of participants using sunscreen. Men exhibited a higher prevalence of negative attitudes towards sun protection, while women demonstrated more favourable sun protection practices. In addition, (1.25 %) of the participants had skin cancer in the past; (81.0 %) of participants agreed that skin cancer could cause death, while (19.0 %) were unsure of the effects of skin cancer. Moreover, the results indicated that sun exposure had a significant positive effect on awareness levels (p < 0.05), indicating that increased sun exposure was associated with higher awareness of the harmful effects of the sun. Additionally, awareness level significantly positively affected sunscreen use (p < 0.01), suggesting that individuals with higher awareness were more likely to use sunscreen.

Conclusion

There was an average awareness of sun exposure and its detrimental effects. In addition, a significant portion of the population demonstrates proactive measures to minimize sunlight exposure. However, sunscreen usage among Saudi adults was low despite having knowledge and awareness. Future research must enhance sun protection practices and reduce sun-related skin damage in the Aseer region.

Development and validation of a knowledge, attitude, and practice (KAP) questionnaire for skin cancer in the general public: KAP-SC-Q

BACKGROUND

Skin cancer has emerged as a significant worldwide public health issue, with the global reporting of approximately 1.4 million cases of non-melanoma skin cancer and 287,723 cases of melanoma in 2020. Early detection and prevention are pivotal in battling this disease. However, there is an absence of standardized tools designed to comprehensively gauge these elements.

OBJECTIVE

The study aimed to formulate and examine the validity and reliability of the Knowledge, Attitude, and Practice of Skin Cancer Questionnaire (KAP-SC-Q).

METHODS

The research was conducted in two phases. Phase I included the generation and construction of items, content validity, and pilot testing. In Phase II, the questionnaire was distributed to 370 non-health background public adults in Malaysia. The validity and reliability of the questionnaire were ascertained using Item Response Theory (IRT) for the knowledge domain, exploratory factor analysis (EFA) for the attitude and practice segments, and Cronbach's alpha.

RESULTS

The definitive version of the KAP-SC-Q had 108 items, divided into 17 social demographic, 30 knowledge, 32 attitude, and 29 practice items. Knowledge items had an acceptable range of 0.4-2.0 in the IRT. The EFA revealed that attitude and practice sections contributed to 34.25% and 52.94% of the total observed variance, respectively. The Cronbach's α coefficient was 0.85, signifying good internal consistency.

CONCLUSION

The study validated that KAP-SC-Q exhibits commendable psychometric attributes, marking it as a trustworthy instrument to assess the public's knowledge, attitude, and practices concerning skin cancer.

Skin Cancer-Related Health Behavior Interventions in the Context of the Health Belief Model

The incidence of skin cancer is increasing around the world every year. Although there are many reasons for the occurrence of skin cancer, UV radiation caused by sunlight is seen as the most important factor. Therefore, reducing exposure to UV radiation should be a top priority for skin cancer prevention. In addition, different demographic features also affect the amount of UV exposure. These include age, gender and professional groups. On the other hand, people can be exposed to UV radiation voluntarily. Sunbathing or using tanning devices can be shown as examples for this. For these reasons, interventions to reduce exposure to UV radiation should focus on demographic features and the desire to tan. At the same time, it is emphasized in the literature that theory-based and systematic interventions are more effective than others. In this context, we think that the Health Belief Model, which is an effective psychosocial model for health behaviors, will be useful in developing sun protection behaviors. In this review, interventions based on the Health Belief Model in the context of tanning behavior, age, gender, and outdoor activities for the prevention of skin cancer and the improvement of sun protection behaviors have been discussed.

Knowledge and Protective Behaviors of Teachers on Skin Cancer: A Cross-Sectional Survey Study from Turkey

BACKGROUND

People socialize and receive education and training for the first time outside the home at school, where their teachers act as role models. Teachers play a crucial role in instilling sun-protection habits in children. Avoiding the sun between 10 a.m. and 4 p.m., staying in the shade, wearing sun-protective clothing, wearing sunglasses, wearing hats, using sunscreen products, and using an umbrella are some of the sun-protection methods described in the literature. This study sought to assess teachers' skin cancer knowledge and attitudes (SC).

METHODS

In this cross-sectional study conducted between 21 September 2020, and 21 October 2020, 647 teachers from 30 schools in Kahramanmaras were included with their consent. The number of teachers employed at Kahramanmaras was 1863. Accordingly, the sample was found to be 641 with a 5% margin of error and a 99% confidence interval. Schools were selected by a simple random method. Teachers' knowledge and behaviors were assessed using a 25-point questionnaire designed by the literature data to gauge the level of SC knowledge.

RESULTS

Of the 647 teachers included in this study, 230 (35.5%) were male, and 417 (64.5%) were female. The mean age of the participants was 38.44 ± 8.79 (min = 22, max = 65) years. The knowledge level of the teachers about SC was 13.54 ± 4.48 (min = 0, max = 23). The internet (75.9%) was the most preferred source of information. SC knowledge level was significantly higher in those with SC in their families and birthmarks on their bodies. (p < 0.001, p = 0.042, respectively). The rate of precaution taken to protect from the sun was higher in those with higher knowledge (p = 0.032). Women, primary school teachers, those with skin type 1, those with multiple nevi, and those with a high level of SC knowledge used statistically significantly more sunscreen (p = 0.001, p = 0.003, p < 0.001, p = 0.037, p = 0.002, respectively).

CONCLUSIONS

It was found that the knowledge level of teachers about skin cancer and sun-protective behaviors was moderate. Correct behaviors increased as knowledge about SC grew. Information and recommendations made on the Internet should be made by experts. Additionally, health policymakers should implement projects aimed at improving teachers' knowledge and behaviors and, through them, teaching students about SC; as such projects would significantly contribute to both public health and health economics.

Knowledge and Attitudes of Cypriots on Melanoma Prevention: Is there a Public Health Concern?

Background

Melanoma is the deadliest type of skin cancer. It is the eighth most common cancer in males and the tenth in females in Cyprus, an island in the Mediterranean with a high ultraviolet (UV) index. Cyprus is expected to be strongly affected by climate change and consequently, melanoma will likely become an increasing public health problem. Melanoma prevention is possible; however, it is unknown if people living in Cyprus are aware of melanoma and prevention methods. To this end, we used a validated survey to evaluate the level of melanoma knowledge and factors associated with it in the Cypriot population.

Methods

We conducted a 47-item survey with sections on demographics, knowledge of melanoma and risk factors, attitudes toward relevant health practices, and protective behaviors among six hundred Cypriot residents from October 2015 to April 2016.

Results

Our results revealed that only 59% of participants check their skin for moles, 87% protect their skin from the sun during summer holidays, and 57% do not take measures to protect their skin from the sun during non-holiday periods. Protective behavior was positively associated with educational level (P=0.016) and district of residence (P<0.0001). Melanoma knowledge was positively associated with education level (P=0.002) and district of residence (P=0.004). Level of Concern was positively associated with age (P=0.026) and education level (P=0.041).

Conclusions

There are gaps in melanoma knowledge and prevention practices in the study population. Further education on melanoma and its prevention should be specifically targeted to individuals of lower education levels as well as teenagers, such that protective behaviors for melanoma are adopted early in life.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12324-0.

UV-Induced Skin Cancer Knowledge, Sun Exposure, and Tanning Behavior among University Students: Investigation of an Opportunity Sample of German University Students

Ultraviolet radiation (UVR) is the most important risk factor for developing skin cancer. University students can be considered as a particularly high-risk group for long- and short-term adverse effects of UVR due to intensive solar UVR exposure and high rates of sunburn. While validated questionnaires for assessing solar UVR exposure and sun protection behavior are available in German, a questionnaire for assessing the level of knowledge about this topic is still missing. We conducted a literature search for cross-sectional studies assessing skin cancer and sun protection knowledge among university students in Medline (via PubMed) and analyzed existing questionnaires and topics contained therein. We chose to translate the "Skin Cancer and Sun Knowledge Scale" referring to the TRAPD method into the German language and pilot-tested the translation with an opportunity sample of German students. The literature search revealed 36 eligible studies. Four major topics were identified within the studies: knowledge on skin cancer, risk factors, UVR, and sun protection measures. One hundred and seven German university students (86.0% female) with a mean age of 26.25 years (SD ± 4.58; range: 19-46) participated in our pilot study. The internal reliability of the scale was KR-20 = 0.624. We discovered an improvable level of knowledge in terms of skin cancer among the study population. Statistical analyses revealed no significant associations between the level of knowledge and UVR exposure or tanning behavior, respectively. The skin cancer and sun protection knowledge of German university students should be examined thoroughly. While the psychometric properties of the SCSK require further thorough investigation, first empirical experiences indicate the suitability of the tool to assess the level of knowledge regarding skin cancer and sun protection.

Effects of a health education intervention on knowledge and attitudes towards chronic non-communicable diseases among undergraduate students in Jordan

Aim

To assess the effect of a health promotion course on knowledge and attitudes towards chronic non-communicable diseases (CNCDs) among undergraduate students in a Jordanian university.

Design

A one-group pre-test-post-test study design was used.

Methods

A convenience sample of 178 undergraduate students registered in a 3-credit health promotion course was enrolled in the study and completed both pre- and post-tests. This course is offered as an elective course for undergraduate students by the Faculty of Nursing at a large public university in Jordan. Twelve, one-hour interactive sessions regarding CNCDs topics were delivered over 3 weeks as part of the health promotion course. A computer-based questionnaire was used to evaluate students' knowledge and attitudes towards CNCDs including diabetes, hypertension and cancer, before and after undertaking the course.

Results

There was a significant improvement in the overall knowledge (Cohen's d effect size (d) = 1.08) and attitudes (d = 0.62) among all the students, regardless of gender. The overall knowledge and attitudes scores were significantly higher among females in the pre-test, but the differences in their overall scores became insignificant in the post-test. Education on specific topics was effective in improving university students' knowledge and attitudes about health-promoting behaviours, thereby preventing CNCDs. It is important to incorporate health promotion education regarding CNCDs into university curricula using innovative approaches to enhance healthy behaviours in young adults.

Effects of an Education Intervention on Nursing Students' Knowledge and Attitudes Regarding Skin Self-Examination and Skin Cancer Risks

BACKGROUND

The incidence of skin cancers is increasing in Turkey as well as worldwide. Nurses have a potentially influential role to play in educating the public about skin cancer prevention.

PURPOSE

The purpose of this study was to teach nursing students the risks of skin cancer and the steps involved in conducting related skin self-examinations to encourage positive attitudes toward skin cancer protection and early detection.

METHODS

This research used a quasi-experimental, single-group, pretest-posttest design. The study population was composed of all the nursing students who were currently enrolled in a university in Muğla, a city in southern Turkey (n = 900). The study analysis included the 332 nursing students who had completed both the pretest and posttest assessments. An intervention to raise awareness about skin cancer risks and skin self-examination was carried out using educational materials that included posters/pictures, brochures, a PowerPoint slideshow, and a video. The posttest assessment was done 6 weeks after the pretest.

RESULTS

The participants were 18-23 years old, and 67.5% were female. Furthermore, 3.6% had undergone a routine (external) screening for skin cancer, and 14.5% believed that they were at risk for skin cancer. The mean score for knowledge of skin cancer risks for those participants who had completed the program was 5.75 ± 1.20 in the pretest and 6.84 ± 1.17 in the posttest (minimum: 0, maximum: 8). The mean posttest score was higher than the pretest score in this group, F(1, 329) = 6.49, p = .011, and a significant difference was found between the mean pretest and posttest score for knowledge of the ABCDE rule (p < .05).

CONCLUSIONS

Educating nursing students about skin self-examination increased their level of knowledge about both skin cancer risks and the ABCDE rule. We believe that this and similar educational programs are an effective way to increase the knowledge and awareness of nurses regarding skin cancer and to improve their attitudes toward performing skin self-examination.

A Self-Reported Study Toward Melanoma Knowledge, Protective Behavior and Personal Risk Among Nursing Faculty Students at AAB University of Kosovo

Introduction

In nowadays, melanoma is one of the major problems of public health all over the world. In Kosovo, the incidence of melanoma has shown irregular tendency with significant increases and decreases in the last five years.

Aim

The aim of this paper was to detect the knowledge level of nursing students in Kosovo's University (AAB University) regarding melanoma and its risk factors; to evaluate their knowledge about the protection and prevention methods of melanoma as one of the main topics of dermatology and major problems of public health worldwide nowadays. Of a great importance, it was to evaluate the necessity of establishing a dermatology course in nursing curricula in Kosovo universities, as nurses have a key role in educating and promoting health in the population.

Methods

The training was conducted through slides, photos, videos and a questionnaire was used to collect the data before and after training. Data analysis was run through SPSS program version 20.0. Data were expressed through mean values and standard deviations. T-test, Anova and regression analysis were performed to test the relationship between the protective behaviors, knowledge, personal risk and level of concern.

Results

Results indicated a low level of knowledge and a fairly poor protective behavior among the participants.

Conclusion

On-going training and enrichment of school curricula emerged as an intervention to increase the awareness of the students toward potential risks of melanoma and ultimate change in the protective behavior.

Knowledge, attitude, and practices toward sun exposure and use of sun protection among non-medical, female, university students in Saudi Arabia: A cross-sectional study

Excessive unprotected sun exposure is a significant risk factor for skin damage and skin cancers. In recent decades, the incidence of skin cancer has increased dramatically worldwide, reaching epidemic proportions. Skin cancer is the most common type of cancer worldwide, and the ninth most common malignancy in Saudi Arabia. Sun protection is a key primary preventive strategy against skin cancer and skin damage induced by sun exposure.

Herein, a cross-sectional study was made to evaluate the knowledge, attitude, and practices toward sun exposure, and the use of sun protection among non-medical female students on the Sulaymaniyah campus of the King Abdul-Aziz University. Also, we identified the reasons that prevented the students from using sun protection measures. A special-designed, self-administered questionnaire was applied on a sample size of 501 students. We found that most students were aware of the risks of unprotected sun exposure. Nevertheless, a view of sunscreen as harmful was reported (34.1%). Seeking shade and wearing protective clothing were the most used sun protection methods (58.1% and 43.1%, respectively). Sunscreen users made up only one third of our sample (23.6%). However, the majority of students (64.9%) did not know about the sun protection factor of sunscreen products. Discomfort felt on the skin was the most commonly reported reason for avoiding the use of sunscreen (40.7%). When comparing our study with Western studies, we found a high level of awareness among our sample of students. Significant differences in the attitude toward the application of suntan and sun protection products might be due to differences in cultural background. Our results spotted the need for future health education programs for our society that focus on the significant importance of sunscreen, as well as the correct methods of application.