Assessment of attitudes towards sun-protective behaviour in Australians: A cross-sectional study

Public knowledge, attitudes, practices, and barriers to skin cancer screening in the United Arab Emirates

OBJECTIVE

To assess knowledge, attitude, practice, and barriers to skin cancer screening among the general population of the United Arab Emirates (UAE).

METHODS

In this cross-sectional study, an online-based questionnaire was distributed via online social media sites such as Facebook, WhatsApp, Twitter, and others to the residents of the UAE. The questionnaire evaluated socio-demographics, knowledge (8 items), attitudes (10 items), practices (14 items), and barriers (9 items) in the context of skin cancer screening. A binary logistic regression was conducted to assess variables associated with practice levels.

RESULTS

The study included 924 participants (51.9% females), with a median (IQR) age of 32 (22-44) years. Results showed a window for knowledge improvement [median = 4 (3-6) out of a maximum potential score of 8], unfavourable attitudes [median = 37 (33-39) out of a maximum potential score of 50], inadequate practices [median = 41 (31-45) out of a maximum possible score of 70]. The most common barriers to skin cancer screening were lack of knowledge about skin cancer (74.1%), lack of awareness of the need for skin cancer screening (72.2%), and absence of symptoms (54.1%). Older age (OR = 0.985, 95%CI: 0.971-0.998) and lack of health insurance (OR = 0.478, 95%CI: 0.301-0.758) were associated with lower screening practices. Female gender (OR = 1.833, 95%CI: 1.361-2.469), being married (OR = 1.415, 95%CI: 1.006-1.992), being a non-smoker (OR = 1.568, 95%CI: 1.045-2.352) or a former smoker (OR = 2.555, 95% CI: 1.082-6.034), and more favourable attitudes (OR = 1.071, 95%CI: 1.044-1.096) were associated with higher screening practices.

CONCLUSION

The UAE population exhibited moderate knowledge, unfavourable attitudes, and inadequate practices regarding skin cancer screening, with several barriers identified. Targeted online and in-person awareness campaigns are crucial for improving public understanding and attitudes, thereby enhancing screening practices, especially among older adults, males, smokers, and those without health insurance.

Knowledge, Attitude, and Practice toward Skin Cancer among Patients of Dermatology Clinics and Medical Students/General Practitioners

This cross-sectional study assessed the knowledge, attitude, and practices (KAP) regarding skin cancer among dermatology clinic patients, medical students, and general practitioners (GPs) in Tehran, Iran. The researchers collected data using a validated questionnaire administered online, measuring KAP on scales of 0-31, 0-16, and 0-28, respectively, with scores above 16, 8, and 14 indicating "good" levels. Of 2243 participants (mean age 28 years), 59.4% had good knowledge, 19.8% had good attitudes, 31.8% had good practices, and 29.8% had good overall KAP. Medical students/GPs scored higher on knowledge and attitudes, while patients scored better on practices. Knowledge, attitudes, and practices were positively correlated in professionals but inversely correlated in patients. The findings suggest that while knowledge was moderate, attitudes and behaviors remained poor, particularly among patients. Immediate interventions are needed to improve attitudes and prevention practices, as public health initiatives must focus on positively influencing both to translate knowledge into meaningful action and find the reasons why good knowledge may not always lead to good practice. These findings underline the need for targeted interventions to bridge the gap between knowledge and preventive behaviors, to effectively reduce the burden of skin cancer in the population.

Evaluation of social knowledge on photoprotection and its relationship with education and age in a Polish seaside town during summer holidays

OBJECTIVE

This survey aimed to evaluate knowledge of photoprotection among individuals from a random group in a resort town in Poland, Kołobrzeg, and explore the correlation between their knowledge and demographics like age, gender, education, and residence.

METHODS

An anonymous survey was conducted among a diverse group. This population comprised individuals from various backgrounds: health spa patients undergoing treatments, therapies and medical appointments, guests visiting the resort for leisure, passersby, and staff working at the spa and recreational facilities. The survey was designed by authors, encompassed 16 questions about knowledge on photoprotection, sunscreen use and related topics, and gathered demographic data. Responses from 142 individuals were statistically analyzed using PQStat Software.

RESULTS

Only 7.7% use sunscreen all year-round. The majority apply sun protection factor (SPF) creams on sunny days or with prolonged sun exposure. Over half of the respondents (53.5%) are aware when to apply sunscreen but 43% reapply it less than every 4 h. 25.4% do not reapply at all. 38.7% think protection provided by higher SPF means longer sun exposure time. Over 50% believe SPF 30 offers double the protection of SPF 15. Almost half (46.8%) use extra sun protection, like sunglasses or hats. Significant correlations exist between education/age and certain survey responses.

CONCLUSIONS

The findings emphasize the urgency to improve photoprotection knowledge in the Polish population, particularly regarding the year-round harmful solar effects and the correct use of sun protection products.

Interventions to Increase Sunscreen Use in Adults: A Review of the Literature

Skin cancers are the most common malignancy in Australia. Regular sunscreen use can reduce the incidence of cutaneous squamous cell carcinomas and actinic keratoses and has been associated with reducing the incidence of basal cell carcinomas and melanomas. However, sunscreen effectiveness is limited by the failure of the population to use it routinely. Interventions that promote the daily application of sunscreen may reduce the morbidity, mortality, and economic burden associated with skin malignancies. We reviewed the literature that examines the effectiveness of interventions to increase routine sunscreen use and found that no one strategy has been shown to be clearly effective in adults and that relatively few studies have aimed to increase routine use in groups at extreme skin cancer risk. Future research should consider how interventions can be best designed and how sunscreen use is measured so that cost-effective, feasible strategies that result in improved sunscreen use in adults can be established.

Molecular photoprotection of human keratinocytes in vitro by the naturally occurring mycosporine-like amino acid palythine

Background

Solar ultraviolet radiation (UVR) induces molecular and genetic changes in the skin, which result in skin cancer, photoageing and photosensitivity disorders. The use of sunscreens is advocated to prevent such photodamage; however, most formulations contain organic and inorganic UVR filters that are nonbiodegradable and can damage fragile marine ecosystems. Mycosporine‐like amino acids (MAAs) are natural UVR‐absorbing compounds that have evolved in marine species for protection against chronic UVR exposure in shallow‐water habitats.

Objectives

To determine if palythine, a photostable model MAA, could offer protection against a range of UVR‐induced damage biomarkers that are important in skin cancer and photoageing.

Methods

HaCaT human keratinocytes were used to assess the photoprotective potential of palythine using a number of end points including cell viability, DNA damage (nonspecific, cyclobutane pyrimidine dimers and oxidatively generated damage), gene expression changes (linked to inflammation, photoageing and oxidative stress) and oxidative stress. The antioxidant mechanism was investigated using chemical quenching and Nrf2 pathway activation assays.

Results

Palythine offered statistically significant protection (P < 0·005) against all end points tested even at extremely low concentrations (0·3% w/v). Additionally, palythine was found to be a potent antioxidant, reducing oxidatively generated stress, even when added after exposure.

Conclusions

Palythine is an extremely effective multifunctional photoprotective molecule in vitro that has potential to be developed as a natural and biocompatible alternative to currently approved UVR filters.

What's already known about this topic?

Mycosporine‐like amino acids (MAAs) are photoprotective molecules found in marine organisms but there are few data on their ability to protect skin cells from the adverse effects of solar ultraviolet radiation (UVR).

The European Chemicals Agency (ECHA) is concerned about the potential adverse health and ecotoxic effects of eight of 16 commonly used sunscreen filters in Europe. The Environmental Effects Assessment Panel (EEAP) of the United Nations Environment Programme has expressed similar concerns.

What does this study add?

Palythine, an MAA extracted from an edible seaweed, affords photoprotection against a wide range of adverse effects in HaCaT keratinocytes exposed to solar simulating and ultraviolet A radiation. Of note is protection against two types of DNA photolesions; cyclobutane pyrimidine dimers and 8‐oxo‐7,8‐dihydroguanine.

Palythine is also a potent antioxidant that offers protection even when added after UVR exposure.

What is the translational message?

MAAs should be considered for development as natural biocompatible sunscreens that may address the concerns of the ECHA and EEAP.

Linked Comment: https://doi.org/10.1111/bjd.16598.

https://goo.gl/Uqv3dl