A large international survey on sun exposure behaviours and skin cancer detection found there are many imperfections and geographical inequalities in primary and secondary prevention of skin cancer.
The study was published in the Journal of the European Academy of Dermatology & Venereology (Jan. 3, 2017) by researchers from La Roche-Posay and the George Washington University Department of Dermatology in Washington. The investigators received survey responses primarily online from 19,569 people ages 15 to 65 years of age from 23 participating countries.The questionnaire collected data regarding demographics, sun exposure, behaviours regarding prevention and tanning, risk knowledge, self-examination, medical advice seeking, and social attitude.
The results indicate that 88% of those questioned were aware of the risks of developing skin cancer when exposed without protection to the sun. However, just one in two respondents has ever consulted a dermatologist for a mole screening and four in 10 people do not think to protect themselves from the sun unless on vacation.
“This is a global wake-up call,” said Dr. Adam Friedman, senior author of the study and associate professor of dermatology at the GW School of Medicine and Health Sciences, in a press release.
According to the data, using sunscreen and wearing sunglasses were the most frequent preventive measures. Education level, as well as gender, influenced the degree of sun protection: A higher level of education corresponded to a higher level of sun protection. Self-examination and consultation with a dermatologist were positively correlated with socioeconomic status and education level, as well. Women were found to be more knowledgeable than men regarding risk factors and the appropriate measures and resources to prevent and monitor skin cancer.
There were also many regional differences. Inhabitants of countries in Southern and Western Europe were more likely than the average respondent to use sunscreen. In Latin America, sun avoidance was much more common. In Australia, respondents had a more diverse set of protective behaviours, which included trying to stay in the shade, wearing a hat, or wearing protective clothing. Those in Australia, Ireland, Brazil, and Greece were remarkably more informed than other survey participants about the risks and early signs of skin cancer. Conversely, those from Mexico, Russia, and Italy were among the least informed. Overall, Australia and Southern Europe exhibited higher rates of preventive behaviour than average.
In North America, the survey included 1,005 respondents in Canada and 1,000 in the U.S. In terms of screening for melanoma, Americans perform slightly better than the average for other countries. Eighteen per cent of U.S. respondents have their moles checked by a dermatologist at least once a year compared the country average of 11%. However, preventive protection habits in the U.S. are in line with the average observed, indicating more education on sun safety is needed.
While the surveyed populations were aware of risks related to sun exposure, individual risk factors, such as skin type and the size of moles, were not well known by respondents. The data disclosed that self-examination and medical seeking is frequently underused, and early signs of skin cancer that should prompt medical consultation are not universally known.