A profile of skin cancer prevention media coverage in 2009

Wrinkles, brown spots, and cancer: Relationship between appearance- and health-based knowledge and sunscreen use

BACKGROUND

There is increasing understanding that sunscreen use is associated with reduced photoaging and that appearance-based messages are more effective than health-based messages in promoting daily sunscreen use. We hypothesized that persons with greater awareness of the effects of photoaging use sunscreen more consistently.

METHODS

Cross-sectional survey of adults in Dallas, TX, assessing sunscreen-related knowledge, behavior, and information source.

RESULTS

Each respondent averaged 2.5 ± 1.7 hours of self-reported sun exposure daily with the least reported time being 0.15 hours. Eighty-eight percent reported that sun exposure caused skin cancer "a lot." Eighty-nine percent "agreed" or "strongly agreed" that "sun exposure causes most signs of skin aging." Over 70% "agreed" or "strongly agreed" to an appearance-based reason for their sunscreen use. Sixty-six percent reported they would consider using sunscreen if anticipating sun exposure lasting 2 hours or less. Only 30% reported using sunscreen daily. Greater photoaging knowledge was positively associated with sunscreen adherence (at least P < 0.05 with each knowledge item). Those with darker complexions or skin less likely to burn reported less knowledge of photoaging (ρ = -0.219, P ≤ 0.001) and had lower sunscreen use (ρ = 0.301, P < 0.001).

CONCLUSION

Despite most respondents reporting knowledge of health and appearance risks of sun exposure and a motivation to prevent them with sunscreen, most do not use sunscreen adequately. This discrepancy could be due to people perceiving risks of sun exposure based on duration of continuous exposure. There may be misconceptions that short-interval sun exposure that does not result in sunburn is less harmful than extended exposure.

Sun Exposure, Tanning Beds, and Herbs That Cure: An Examination of Skin Cancer on Pinterest

Skin cancer is the most common cancer affecting the U.S.

POPULATION

Pinterest.com, a virtual bookmarking social media site, has the potential to disseminate skin cancer-related information among young women, the group with the fastest increase in skin cancer diagnosis. This article presents a quantitative content analysis of pins about skin cancer on Pinterest guided by agenda-setting theory and the health belief model. Overall, sun exposure and tanning beds were most frequently discussed as the causes of skin cancer, and alternative therapies such as herbal medicine were discussed more than traditional biomedical treatment or prevention. Highly repinned pins tend to include more information than regular pins. Different types of skin cancer (melanoma, squamous-cell carcinoma, and basal-cell carcinoma) received the same amount of coverage; however, pins about nonmelanoma skin cancer (such as squamous-cell carcinoma and basal-cell carcinoma) were often information-poor. They were less likely to include information on the causes, prevention, and the biomedical treatment of skin cancer and were less likely to include health belief constructs associated with the promotion of skin cancer prevention and treatment.

Coverage of Skin Cancer Risk Factors and UV Behaviors in Popular U.S. Magazines from 2000 to 2012

Mass media is an influential source of skin cancer and tanning information for the public, but we know little about its content or emphasis. The objective of this research was to describe the volume and nature of skin cancer and tanning messages in 20 popular U.S. men's and women's magazines (2000-2012). We used a directed content analysis to determine frequency information about risk factors and ultraviolet (UV) behaviors in 608 articles and 930 images. Chi-square and Fisher's exact tests determined coverage differences based on content type (text vs. image) and target audience (women vs. men). UV exposure was the most common risk factor mentioned (37.7 %) and sunscreen use the most common behavior encouraged (60.0 %); information about other risk factors and protective behaviors was uncommon. Both articles (25.2 %) and images (36.9 %) promoted the tanned look as attractive. In most cases, images infrequently contained helpful information on skin cancer risk factors and prevention, except for high-SPF sunscreens. Women's magazines published more articles on skin cancer and tanning than men's magazines (456 vs. 159, χ(2) = 143.43, P < .01), and the nature of the messages differed between them. Magazine skin cancer and tanning content may contribute to inaccurate public understanding of risks and prevention. These findings are relevant to cancer educators, who may wish to counter potentially harmful messages and enhance positive ones through cancer education efforts.

Patterns of sunscreen use on the face and other exposed skin among US adults

BACKGROUND

Sunscreen is a common form of sun protection, but little is known about patterns of use.

OBJECTIVE

We sought to assess patterns of sunscreen use on the face and other exposed skin among US adults.

METHODS

Using cross-sectional data from the 2013 Summer ConsumerStyles survey (N = 4033), we calculated descriptive statistics and adjusted risk ratios to identify characteristics associated with regular sunscreen use (always/most of the time when outside on a warm sunny day for ≥1 hour).

RESULTS

Few adults regularly used sunscreen on the face (men: 18.1%, 95% confidence interval [CI] 15.8-20.6; women: 42.6%, 95% CI 39.5-46.7), other exposed skin (men: 19.9%, 95% CI 17.5-22.6; women: 34.4%, 95% CI 31.5-37.5), or both the face and other exposed skin (men: 14.3%, 95% CI 12.3-16.6; women: 29.9%, 95% CI 27.2-32.8). Regular use was associated with sun-sensitive skin, an annual household income ≥$60,000, and meeting aerobic activity guidelines (Ps < .05). Nearly 40% of users were unsure if their sunscreen provided broad-spectrum protection.

LIMITATIONS

Reliance on self-report and lack of information on sunscreen reapplication or other sun-safety practices are limitations.

CONCLUSION

Sunscreen use is low, especially among certain demographic groups. These findings can inform sun-safety interventions and the interpretation of surveillance data on sunscreen use.

The impact of indoor tanning legislation: newspaper coverage of the risks of indoor tanning before and after the California indoor tanning ban for minors

On June 1, 2011, the California Senate passed a bill banning minors from indoor tanning. We aimed to determine whether the bill's passage was associated with longer-term media coverage regarding skin protection and the risks associated with indoor tanning. Articles from 31 English-language California newspapers between June 2010-May 2011 (PRE) and June 2011-May 2012 (POST) were searched using terms related to skin protection. Ninety articles were found for in-depth coding and analysis. There were more skin protection articles in the POST period than in the PRE period (57 vs 33; p < .05). In addition, there were more POST articles mentioning the risks of indoor tanning (33 vs 10; p < .001), and a POST article was more likely to mention the risks (58 vs 30%; p < .05). The higher number of POST articles mentioning the risks persisted throughout all quarters. Therefore, the California indoor tanning ban was associated with increased longer-term news coverage of skin protection and the risks associated with indoor tanning. This finding has potential influence on the many states that are considering comparable legislation.

Assessing the current market of sunscreen: a cross-sectional study of sunscreen availability in three metropolitan counties in the United States

Sunscreen use is recommended for the prevention of sunburn and skin cancer. Little is known regarding sunscreen availability in high versus low income communities. We analyzed sunscreen availability in three large metropolitan counties to determine the relationship between availability and community demographics. We included sun care products in all pharmacies and supermarkets open as of July 2013 in representative high and low income zip codes in Cook County, Illinois, Miami-Dade County, Florida, and San Diego County, California. We recorded the percentage of tanning oil, sunscreens with a sun protection factor (SPF) < 15, SPF > 15, physical sunscreens, spray sunscreens, mean price per ounce (PPO), and mean SPF. Of the total products assessed, 11.0% were tanning oils, with physical sunscreens accounting for only 3.4% of the available sunscreens and 46.2% of sunscreens being spray-on. A comparison between higher and lower income zip codes demonstrated a significantly increased percentage of sunscreens with SPF < 15 in high income zip codes. Lower income zip codes had higher percentages of sunscreens with SPF > 15 and higher PPO, even when taking into account SPF. Further studies of sunscreen usage patterns in different populations must take into account sunscreen availability and price, as these significantly differ based on the community demographic.

Changes in coverage of sun protection in the news: threats and opportunities from emerging issues

This study aimed to determine whether there have been shifts in news coverage of sun protection issues over a 12-year period in the context of an evolving skin cancer prevention agenda. A content analysis was performed on all relevant articles (N = 552) published in the two metropolitan daily newspapers in Melbourne, Australia, from 2001 to 2012. Coding variables included theme, article type, prominence, spokesperson and topic slant. Articles were collapsed into three 4-year blocks and a series of chi-square analyses conducted to examine changes over time in coverage of topical issues (i.e. vitamin D and sunbeds) and established sun protection themes [i.e. health effects of ultraviolet (UV) exposure, education/prevention, attitudes/behaviour]. Coverage of vitamin D and sunbed issues increased over time and became more positive for sun protection objectives. The proportion of articles reporting on established sun protection themes remained steady over time (range: 36-38%) and there were no changes observed in the way these topics were presented in the news media. These results highlight that potentially competing sun protection issues that emerge over time need not pose a threat to existing skin cancer prevention programmes but instead can provide opportunities to further spread programme messages while increasing credibility.

An examination of direct and indirect effects of exposure and attention to health media on intentions to avoid unprotected sun exposure

Skin cancer is the most commonly diagnosed cancer in the United States, accounting for more than 2 million diagnoses and more than 9,000 deaths annually. A regional online survey of students enrolled at institutions of higher education (N = 1,251) examined (a) associations between health media use and intentions to avoid unprotected sun exposure and (b) theoretically derived health behavior constructs that may mediate the relationship between media use and individuals' decisions to avoid unprotected sun exposure. Individuals with greater exposure and attention to health information in television, magazines, and newspapers had higher intentions to avoid unprotected sun exposure. Multiple mediation models indicated that health behavior constructs collectively mediated the relationship between television use and sun-protective behavioral intentions. Both cumulative and specific indirect mediating effects were observed for the relationship between magazine use and sun-protective behavioral intentions. However, the direction of effects was opposite to the hypothesized direction, due primarily to the association of magazine use with less favorable attitudes about sun protection and reduced behavioral control to avoid unprotected sun exposure. This study provides preliminary evidence for the interrelationships among media use, internal psychological states and cognitions, and health behavior decision making. Future studies should further explicate the mediating processes that account for the relationships between media and health behavior.

Time to get serious about skin cancer prevention

In this commentary, we discuss the skin cancer epidemic in the United States and provide data to indicate that the United States public is not protecting itself from ultraviolet radiation, the primary risk factor for melanoma, and nonmelanoma skin cancer. In our opinion, skin cancer control in this country may be hindered by uncertainty about the effectiveness of sun protection strategies, inconsistent messages about the relative effectiveness of sun protection measures by federal and national organizations, and conventional research approaches that have identified few effective sun protection interventions for adults and targeted individuals for behavior change without considering the environmental context. A policy and research agenda is put forth to remedy the apparent insufficiencies in the current approach to skin cancer prevention in the United States.