Primary prevention of keratinocyte carcinoma among outdoor workers, the general population and medical professionals: a systematic review updated for 2019

Abstract

Worldwide 2–3 million cases of keratinocyte carcinoma (KC) are diagnosed annually. Sun‐related knowledge is essential for adequate protection against solar ultraviolet radiation (UVR), the main risk factor for KC. The goal was (i) to provide an updated overview of primary prevention against KC including skin cancer‐related knowledge, attitudes and sun protection behaviour (SPB) of outdoor workers, the general population and medical professionals as well as (ii) to evaluate the effectiveness and acceptability of sun protection programmes. We conducted a systematic review of articles indexed for MEDLINE on PubMed using selected MeSH terms and keywords related to the studied topic as well as an extensive hand search of publications between 1 January 2012 and 31 December 2018. We identified 51 relevant cross‐sectional studies and 22 interventional studies. Sun‐related knowledge and attitude showed substantial differences with some alarming results, including people who had not even heard about skin cancer before. Reported SPB varied enormously between the included studies, with none of the studies providing an overall sufficient SPB in their examined sun protection measures. However, sun protection programmes using new technologies seem to have great potential to increase sun‐related knowledge and SPB. In countries worldwide, particularly in those where KC is not yet a public health issue, UVR protection should be promoted by healthcare institutions and authorities, politicians, cancer foundations and dermatologists to increase awareness as well as SPB and to decrease the worldwide burden of KC.

Awareness about proper use of sunscreen in people of color: A Jordanian‐based survey

“…The findings of this study in a population with predominance of dark skin color are consistent with the general trend of lack of awareness about proper use of sunscreen in other populations . The findings of this study indicate a clear difference in the use of sunscreens between males and females.…”

Primär- und Sekundärprävention von Hautkrebs in ländlichen Regionen

“…Obwohl aktuelle Studien für Deutschland einerseits auf ein geringeres Hautkrebsrisiko andererseits auf eine spätere Diagnosestellung sowie Behandlung von Hautkrebs für die ländliche Bevölkerung verglichen mit der Stadtbevölkerung hinweisen [3,17], liegen bisher kaum Daten zur Inanspruchnahme von Sonnenschutzmaßnahmen in der ländlichen Bevölkerung Deutschlands vor. Basierend auf Untersuchungsergebnissen anderer Länder [7,13] und verschiedener Außenberufsgruppen in Deutschland, die überwiegend im ländlichen Raum tätig sind [25,28,30], lässt sich jedoch eine geringe Anwendung von Sonnenschutzmaßnahmen in der deutschen Landbevölkerung ableiten.…”

Solar Ultraviolet Exposure in Individuals Who Perform Outdoor Sport Activities

“…(Supplementary Table 3) Despite overwhelming scrutiny, the UVI has been adopted by many governments as the standard platform for public communication of UV exposure risk since its inception by the WHO 1994 [37]. Many of the research efforts detailing UVI knowledge have shown there is a minimal understanding of the UVI by the public [51,54,[85][86][87][88][89][90] and that lower UVI value recommendations underpredict erythemal risk [91][92][93]. Medical professionals have similarly displayed limited knowledge or use of the UVI [94][95][96].…”