Sun exposure and protection habits: Self-reported attitudes, knowledge and behaviours.
Journal
Journal of the European Academy of Dermatology and Venereology : JEADV
ISSN: 1468-3083
Titre abrégé: J Eur Acad Dermatol Venereol
Pays: England
ID NLM: 9216037
Informations de publication
Date de publication:
13 May 2024
13 May 2024
Historique:
received:
22
09
2023
accepted:
28
02
2024
medline:
13
5
2024
pubmed:
13
5
2024
entrez:
13
5
2024
Statut:
aheadofprint
Résumé
As exposure to UV radiation is the primary modifiable environmental risk factor associated with skin cancer, it remains the principal focus of most prevention strategies. Numerous sun protection campaigns have been implemented worldwide; however, their impact on the actual incidence and mortality rates of skin cancer seems to be limited. To create successful skin cancer prevention campaigns, it is important to have a comprehensive understanding of individuals' attitudes and behaviours regarding sun protection. The aim of the current study was to determine and report on the prevalence of self-reported attitudes, knowledge and behaviours regarding two of the major sun protection recommendations-avoidance of sun exposure and use of sunscreens-in an international representative sample across five continents. This cross-sectional study was conducted in 20 countries using a web-based online survey. A total of 50,552 individuals, comprising 25,388 men (50.22%) and 25,164 women (49.78%), participated in the survey. Among them, 83.2% reported having been voluntarily exposed to the sun (for sun-basking reasons) at least once in the last 12 months, and 47.96% acknowledged being exposed to the sun between the hours of 10 AM and 4 PM. The primary reason for non-adherence was that these hours were the most convenient times (32.28%). Only 24.05% reported applying sunscreen every 2 h when outdoors. Forgetfulness was the primary reason as provided by 27.79% of participants. Males and older age groups were less likely to adopt sun-protective behaviours around the world. Forgetfulness and the challenges posed by time constraints seem to be the biggest barriers to proper adherence. These findings should prompt the collaboration with health authorities and the manufacturers to enhance adherence by setting reasonable sunscreen prices and creating formulations that make their application less burdensome.
Sections du résumé
BACKGROUND
BACKGROUND
As exposure to UV radiation is the primary modifiable environmental risk factor associated with skin cancer, it remains the principal focus of most prevention strategies. Numerous sun protection campaigns have been implemented worldwide; however, their impact on the actual incidence and mortality rates of skin cancer seems to be limited. To create successful skin cancer prevention campaigns, it is important to have a comprehensive understanding of individuals' attitudes and behaviours regarding sun protection. The aim of the current study was to determine and report on the prevalence of self-reported attitudes, knowledge and behaviours regarding two of the major sun protection recommendations-avoidance of sun exposure and use of sunscreens-in an international representative sample across five continents.
METHODS
METHODS
This cross-sectional study was conducted in 20 countries using a web-based online survey.
FINDINGS
RESULTS
A total of 50,552 individuals, comprising 25,388 men (50.22%) and 25,164 women (49.78%), participated in the survey. Among them, 83.2% reported having been voluntarily exposed to the sun (for sun-basking reasons) at least once in the last 12 months, and 47.96% acknowledged being exposed to the sun between the hours of 10 AM and 4 PM. The primary reason for non-adherence was that these hours were the most convenient times (32.28%). Only 24.05% reported applying sunscreen every 2 h when outdoors. Forgetfulness was the primary reason as provided by 27.79% of participants. Males and older age groups were less likely to adopt sun-protective behaviours around the world. Forgetfulness and the challenges posed by time constraints seem to be the biggest barriers to proper adherence.
INTERPRETATION
CONCLUSIONS
These findings should prompt the collaboration with health authorities and the manufacturers to enhance adherence by setting reasonable sunscreen prices and creating formulations that make their application less burdensome.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Patient Centricity by Pierre Fabre
Informations de copyright
© 2024 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.
Références
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–249. https://doi.org/10.3322/caac.21660
Urban K, Mehrmal S, Uppal P, Giesey RL, Delost GR. The global burden of skin cancer: a longitudinal analysis from the Global Burden of Disease Study, 1990–2017. JAAD Int. 2021;2:98–108. https://doi.org/10.1016/j.jdin.2020.10.013
Lomas A, Leonardi‐Bee J, Bath‐Hextall F. A systematic review of worldwide incidence of nonmelanoma skin cancer. Br J Dermatol. 2012;166(5):1069–1080. https://doi.org/10.1111/j.1365‐2133.2012.10830.x
World Health Organization. Radiation: ultraviolet (UV) radiation and skin cancer. World Health Organization; n.d. Available from: https://www.who.int/news‐room/questions‐and‐answers/item/radiation‐ultraviolet‐(uv)‐radiation‐and‐skin‐cancer#:~:text=Currently%2C%20between%202%20and%203,skin%20cancer%20in%20their%20lifetime. Accessed 01 Nov 2023.
Arnold M, de Vries E, Whiteman DC, Jemal A, Bray F, Parkin DM, et al. Global burden of cutaneous melanoma attributable to ultraviolet radiation in 2012. Int J Cancer. 2018;143(6):1305–1314. https://doi.org/10.1002/ijc.31527
Islami F, Goding Sauer A, Miller KD, Siegel RL, Fedewa SA, Jacobs EJ, et al. Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States. CA Cancer J Clin. 2018;68(1):31–54. https://doi.org/10.3322/caac.21440
Arnold M, Kvaskoff M, Thuret A, Guénel P, Bray F, Soerjomataram I. Cutaneous melanoma in France in 2015 attributable to solar ultraviolet radiation and the use of sunbeds. J Eur Acad Dermatol Venereol. 2018;32(10):1681–1686. https://doi.org/10.1111/jdv.15022
Keim U, Gandini S, Amaral T, Katalinic A, Holleczek B, Flatz L, et al. Cutaneous melanoma attributable to UVR exposure in Denmark and Germany. Eur J Cancer. 2021;159:98–104. https://doi.org/10.1016/j.ejca.2021.09.0444
US Department of Health and Human Services. The surgeon general's call to action to prevent skin cancer. Washington, DC: Office of the Surgeon General (US); 2014. [cited 2022 July 7]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK247172/
Asai Y, Armstrong D, McPhie ML, Xue C, Rosen CF. Systematic review of interventions to increase awareness of ultraviolet radiation‐induced harm and protective behaviors in post‐secondary school adults. J Cutan Med Surg. 2021;25(4):424–436. https://doi.org/10.1177/1203475420988863
McNoe BM, Morgaine KC, Reeder AI. Effectiveness of sun protection interventions delivered to adolescents in a secondary school setting: a systematic review. J Skin Cancer. 2021;2021:6625761. https://doi.org/10.1155/2021/6625761
Niu Z, Bhurosy T, Heckman CJ. Digital interventions for promoting sun protection and skin self‐examination behaviors: a systematic review. Prev Med Rep. 2022;26:101709. https://doi.org/10.1016/j.pmedr.2022.101709
Oyebanjo E, Bushell F. A critical evaluation of the UK SunSmart campaign and its relevance to black and minority ethnic communities. Perspect Public Health. 2014;134(3):144–149. https://doi.org/10.1177/1757913913516288
Køster B, Meyer M, Andersson T, Engholm G, Dalum P. Development in sunburn 2007–2015 and skin cancer projections 2007–2040 of campaign results in the Danish population. Medicine (Baltimore). 2018;97(41):e12738. https://doi.org/10.1097/MD.0000000000012738
Misery L, Morisset S, Séité S, Brenaut E, Ficheux AS, Fluhr JW, et al. Relationship between sensitive skin and sleep disorders, fatigue, dust, sweating, food, tobacco consumption or female hormonal changes: results from a worldwide survey of 10 743 individuals. J Eur Acad Dermatol Venereol. 2021;35(6):1371–1376. https://doi.org/10.1111/jdv.17162
Misery L, Reaux‐Le Goazigo A, Morisset S, Seite S, Delvigne V, Cochener B, et al. Association of sensitive eyes with sensitive skin: a worldwide study of 10,743 subjects. Skin Pharmacol Physiol. 2022;35(3):148–155. https://doi.org/10.1159/000522056
Green AC, Williams GM, Logan V, Strutton GM. Reduced melanoma after regular sunscreen use: randomized trial follow‐up. J Clin Oncol. 2011;29(3):257–263. https://doi.org/10.1200/JCO.2010.28.7078
Waldman RA, Grant‐Kels JM. The role of sunscreen in the prevention of cutaneous melanoma and nonmelanoma skin cancer. J Am Acad Dermatol. 2019;80(2):574–576.e1. https://doi.org/10.1016/j.jaad.2018.06.069
Perez M, Abisaad JA, Rojas KD, Marchetti MA, Jaimes N. Skin cancer: primary, secondary, and tertiary prevention. Part I. J Am Acad Dermatol. 2022;87(2):255–268. https://doi.org/10.1016/j.jaad.2021.12.066
Armstrong AW, Watson AJ, Makredes M, Frangos JE, Kimball AB, Kvedar JC. Text‐message reminders to improve sunscreen use: a randomized, controlled trial using electronic monitoring. Arch Dermatol. 2009;145(11):1230–1236. https://doi.org/10.1001/archdermatol.2009.269
Chambergo‐Michilot D, Tellez WA, Becerra‐Chauca N, Zafra‐Tanaka JH, Taype‐Rondan A. Text message reminders for improving sun protection habits: a systematic review. PLoS One. 2020;15(5):e0233220. https://doi.org/10.1371/journal.pone.0233220
Vasconcelos Silva C, Jayasinghe D, Janda M. What can twitter tell us about skin cancer communication and prevention on social media? Dermatology. 2020;236(2):81–89. https://doi.org/10.1159/000506458
Mahé E, Beauchet A, de Maleissye MF, Saiag P. Are sunscreens luxury products? J Am Acad Dermatol. 2011;65(3):e73–e79. https://doi.org/10.1016/j.jaad.2010.06.043
Johal R, Leo MS, Ma B, Sivamani RK. The economic burden of sunscreen usage. Dermatol Online J. 2014;20(6):13030/qt6v0352fw.
Available from: https://www.theguardian.com/world/2023/jun/12/netherlands‐free‐sun‐cream‐record‐skin‐cancer‐levels. Accessed 01 Nov 2023.
Available from: https://www.theguardian.com/society/2023/may/15/charities‐call‐for‐scrapping‐of‐vat‐on‐sunscreen‐amid‐skin‐cancer‐fears. Accessed 01 Nov 2023.
Abroms L, Jorgensen CM, Southwell BG, Geller AC, Emmons KM. Gender differences in young adults' beliefs about sunscreen use. Health Educ Behav. 2003;30(1):29–43. https://doi.org/10.1177/1090198102239257
McKenzie C, Nahm WJ, Kearney CA, Zampella JG. Sun‐protective behaviors and sunburn among US adults. Arch Dermatol Res. 2023;315(6):1665–1674. https://doi.org/10.1007/s00403‐023‐02547‐z
Jackson KM, Aiken LS. Evaluation of a multicomponent appearance‐based sun‐protective intervention for young women: uncovering the mechanisms of program efficacy. Health Psychol. 2006;25(1):34–46. https://doi.org/10.1037/0278‐6133.25.1.34
Matts PJ, Fink B. Chronic sun damage and the perception of age, health and attractiveness. Photochem Photobiol Sci. 2010;9(4):421–431. https://doi.org/10.1039/b9pp00166b
Wiznia LE, Wang J, Steuer AB, Elbuluk N. Deficiency of sun protection advertising exists in consumer magazines across demographic groups and varies by target demographic. J Am Acad Dermatol. 2019;80(4):1139–1141. https://doi.org/10.1016/j.jaad.2018.10.004
Roberts CA, Goldstein EK, Goldstein BG, Jarman KL, Paci K, Goldstein AO. Men's attitudes and behaviors about skincare and sunscreen use behaviors. J Drugs Dermatol. 2021;20(1):88–93. https://doi.org/10.36849/JDD.5470
Hevey D, Pertl M, Thomas K, Maher L, Craig A, Chuinneagain SN. Body consciousness moderates the effect of message framing on intentions to use sunscreen. J Health Psychol. 2010;15(4):553–559. https://doi.org/10.1177/1359105309355335
Williams AL, Grogan S, Buckley E, Clark‐Carter D. A qualitative study examining women's experiences of an appearance‐focussed facial‐ageing sun protection intervention. Body Image. 2012;9(3):417–420. https://doi.org/10.1016/j.bodyim.2012.04.008
Autier P, Boniol M, Doré JF. Sunscreen use and increased duration of intentional sun exposure: still a burning issue. Int J Cancer. 2007;121(1):1–5. https://doi.org/10.1002/ijc.22745