Primary prevention of skin cancer: a review of sun protection in Australia and internationally

Abstract

The incidence of skin cancer is increasing worldwide. Protecting the skin from the sun by wearing protective clothing, using a sunscreen with appropriate sun protection factor, wearing a hat, and avoiding the sun are recommended as primary preventive activities by cancer agencies. In this paper the recent data relating to skin cancer primary preventive behaviour in Australia and other countries is reviewed. Comparison of the studies in a table format summarizing the methods, objectives, participants, findings and implications may be obtained from the corresponding author. The sun protection knowledge, attitudes and behaviour patterns observed in Australia are similar in other countries, although Australian studies generally report higher knowledge levels about skin cancer and higher levels of sun protection. The findings suggest that sunscreen is the most frequent method of sun protection used across all age groups, despite recommendations that it should be an adjunct to other forms of protection. While young children's sun protective behaviour is largely influenced by their parents' behaviours, they are still under protected, and sun protective measures such as seeking shade, avoiding the sun and protective clothing need to be emphasized. Adolescents have the lowest skin protection rates of all age groups. Within the adult age range, women and people with sensitive skin were most likely to be using skin protection. However, women were also more likely than men to sunbath deliberately and to use sun-tanning booths. The relationship between skin protection knowledge and attitudes, attitudes towards tanning and skin protection behaviour needs further investigation. Further studies need to include detailed assessments of sunscreen use and application patterns, and future health promotion activities need to focus on sun protection by wearing clothing and seeking shade to avoid increases in the sunburn rates observed to date.

Comportamento relativo à exposição e proteção solar na população de 15 anos ou mais de 15 capitais brasileiras e Distrito Federal, 2002-2003

“…Como o número de episódios de queimadura por exposição solar na infância parece ser um fator de risco tanto para o câncer de pele melanoma quanto para o não melanoma 4,5,35 , esse grupo etário deveria ser alvo de prevenção primária com relação a esses tipos de câncer. Diversos estudos já foram conduzidos nesse sentido 36,37,38 e espera-se que os resultados, a médio e longo prazo, sejam relevantes. É muito importante, contudo, implementar essas estratégias de prevenção tendo em mente, ao mesmo tempo, que a exposição solar tem efeitos benéficos como, por exemplo, garantir o suprimento de vitamina D necessário 39 , prover relaxamento e bem-estar 40 e aumentar a auto-estima 41 .…”

Associations between authoritative parenting and the sun exposure and sun protective behaviours of adolescents and their friends

“…Stanton et al (2004), from their review of the sun protection literature, suggest that women are more likely to use sun protective measures and have higher levels of knowledge about skin cancer and skin protection than men, but they were also more likely to sunbathe and to use sunbeds.…”

“…Associations have been shown between the attitudes, knowledge and behaviour of adolescents in the arena of sun exposure and sun protection (Stanton et al, 2004). Evidence suggests adolescents have low levels of sun protection behaviours and high levels of sun exposure and sunburns (e.g., Cokkinides et al, 2006;Stanton et al, 2004).…”

“…Evidence suggests adolescents have low levels of sun protection behaviours and high levels of sun exposure and sunburns (e.g., Cokkinides et al, 2006;Stanton et al, 2004). During adolescence sun exposure and sun protection knowledge increase with age, yet there is a decrease in sun protection behaviours (Broadstock et.…”

“…Nonetheless there is evidence to suggest that parents remain a notable influence despite the increasing importance of the peer group (Stanton et al, 2004). Parental influence has recently been suggested as an explanation for a decreasing prevalence of sunburns found in younger adolescents (Cokkinides et al, 2006).…”