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

Abstract

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.

Knowledge, attitudes and practices of the general puplic toward the harmful effects of sun exposure and protection

“…66.9% of respondents did not prefer sitting in the winter sun for long periods of times. Table (7) shows data on sunscreen knowledge and use among our respondents. 42.6% reported that >30 SPF sunscreen was enough for sun protection in the summer and 61.7% believed apply sunscreen on face only.…”

“…one including eight questions appraising sun habits and sun protection behavior, and one including five questions assessing readiness to increase sun protection. The contents of the two sections were developed from previous studies [7]. Part I mapping sun exposure/protection habits, includes eight questions based on five-grade Likert scale scores (0-4 points), resulting in a total score of 0-32 points, reflecting an increasing risk exposure.…”

Sun protection in outdoor workers – Development and validation of standardized questionnaires for behavior and knowledge

“…Data concerning the items' reliability was not available in the original publication or the German pilot study. 25,31 We found it necessary to deviate from the original in two details, which should be noted when comparing SCSK scores across studies in the future. As a first and content-wise negligible change, the correct answer to item 13 is "true" in order to avoid a double negative in the translation.…”

“…32 Recently, the SCSK has been translated and pilot tested with a sample of students of vocational education teaching. 25…”

Sonnenschutz bei Beschäftigten im Freien. Entwicklung und Validierung von standardisierten Fragebögen für Verhalten und Wissen

“…32 Kürzlich wurde die SCSK übersetzt und in einer Pilotstudie mit einer Stichprobe aus Berufsschülern getestet. 25…”