Reported sun exposure, attitudes to sun protection and perceptions of skin cancer risk: a survey of visitors to Cancer Research UK's SunSmart campaign website

Background  Skin cancer is the most commonly diagnosed cancer in the U.K. With the aim of reducing, and hopefully reversing, the year-on-year rise in skin cancer incidence, SunSmart, the U.K.'s national skin cancer prevention campaign, has been hosted by Cancer Research UK since 2003.
Objectives  To gather data about how much time visitors to the SunSmart website spend in the sun, their preferred forms of sun protection and their use of tools such as sun-reactive skin type and ultraviolet (UV) index.
Methods  The study was carried out using a quantitative on-line survey hosted by Cancer Research UK's SunSmart website ( http://www.sunsmart.org.uk ) between May and September 2007.
Results  Just over 2000 respondents completed the survey. Young adults are more likely to experience sunburn than older adults, a factor that was found to be much more important than individual susceptibility to sunburn. Initiatives such as using the UV index to guide sun exposure and checking skin regularly for unusual changes both appeared to be associated with a lower incidence of recent sunburn. The distribution of time spent outdoors by indoor workers during summer months demonstrated clearly how important recreational exposure is in influencing the overall solar UV burden.
Conclusions  This on-line survey, while not entirely representative of the U.K. population, has highlighted those factors that can be effective in reducing the incidence of sunburn, and presumably skin cancer, and that messages about the secondary prevention of skin cancer clearly have some overlap with those advocating primary prevention.     

Evaluation of primary prevention initiatives for skin cancer: a review from a UK perspective

To ensure effective primary prevention of skin cancer, aimed at changing behaviour in the sun, and ultimately at reducing the incidence and mortality rates from skin cancer, sufficient information needs to be known about the relationship between sun exposure and skin cancer, the effectiveness of sun protection measures, and the acceptability and uptake of protective measures by the general public. This review specifically addresses the quality and outcome of studies designed to evaluate the impact of primary prevention initiatives in the U.K. Four main areas of concern are highlighted: (i) teenage behaviour in the sun is difficult to change; (ii) fashion, in part, dictates adult and adolescent behaviour in the sun; (iii) there are practical problems related to response rates, follow-up and interpretation of self-reported behaviour; and (iv) a strategy for primary prevention in the U.K. may be falsely based on the experience and results of Australian and American programmes. Standardized methods for monitoring general population behaviour are needed in the U.K. Evaluation of interventions targeting specific groups, especially parents and young children, and the relative costs of different strategies should be reported. Primary prevention messages and strategies should be adapted to the type of ultraviolet radiation exposure experienced, and the overall low risk of melanoma, while addressing controversies on the health effects of sun exposure and sun screens.     

Multiple senile lentigos of the face, a skin ageing pattern resulting from a life excess of intermittent sun exposure in dark-skinned caucasians: a case-control study

BACKGROUND: Different patterns of skin ageing can be described depending on the predominant lesions, i.e. wrinkles, laxity, atrophy, senile lentigos (SLs), etc. They may correspond to different epidemiological contexts. OBJECTIVES: To identify and assess the epidemiological factors for a skin ageing pattern characterized by a high density of SLs on the face, or 'lentigo ageing pattern' (LAP). METHODS: An age- and sex-matched case-control study was conducted in individuals aged between 60 and 80 years, comparing cases (n = 118) with a very high number of SLs on the face for their age, and controls (n = 118) with no or very few SLs for their age. The cases and controls were recruited in two hospitals. RESULTS: In univariate and multivariate analysis, LAP was associated with skin types III and IV, with frequent sunburns, and with the part of the lifetime cumulative sun exposure which was received during vacations. Conversely, there was no link with the occupational and everyday exposures and the total cumulative exposure. LAP was associated with multiple solar lentigos of the upper back. No relationship was found with postmenopausal hormonal therapy, number of naevi, or freckles. CONCLUSIONS: Different epidemiological factors may account for the different skin ageing patterns. LAP seems to develop preferentially in dark-skinned caucasians who have repeatedly received intermittent and intense sun irradiations throughout their life, and have often developed solar lentigos on the upper back earlier in life, whereas the 'prominent wrinkling' pattern is known to affect light-skinned people and smokers with a life excess of continuous exposure.     

Educational interventions to promote sun-protection behaviors in adolescents in the United States: A systematic review

The most prevalent modifiable risk factor for skin cancer is cumulative lifetime exposure to ultraviolet (UV) radiation, supporting the development of interventions promoting the early adoption of sun-protection behaviors. This systematic review summarizes behavioral interventions designed to promote sun-protection behaviors and reduce harmful UV exposure among U.S. adolescents. Ten studies describing 15 intervention arms were ultimately included in this review and comprised seven cross-sectional studies, a cohort study, a quasi-experimental study, and a randomized controlled trial. Most interventions included in this review were effective in increasing awareness of skin cancer and knowledge of the risk factors for skin cancer, but knowledge did not correlate with self-reported frequency of sun-protection behaviors in this population.