INTRODUCTION

Skin cancer is one of the most prevalent forms of cancer globally, with increasing incidence rates.

This rise may be attributed to various factors, including heightened exposure to UV radiation, changes in lifestyle, and inadequate protective measures against sun damage.

This survey aims to explore the perceptions and awareness of skin cancer risk factors to provide insights that can inform public health campaigns and educational strategies.

MATERIALS AND METHODS

RESULTS

Out of 500 individuals approached, 470 agreed to participate (320 online, and 150 outpatient). After excluding 20 incomplete responses, a total of 450 participants were included in the final analysis.

Among the 450 participants, 71.1% were female (n = 320) and 28.9% male (n = 130). The most represented age group was ≥ 55 years (42.2%), followed by 35–54 years (35.6%), and 18–34 years (22.2%). The majority (86.7%) had a university education, while 2.2% were illiterate. Most respondents lived in urban areas (93.3%), with only 6.7% from rural regions (Table 1).

Table 1: Sociodemographic characteristics of the participants (n=450).

In terms of familiarity, 31.1% of the respondents were very familiar with skin cancer, while 13.3% reported no familiarity at all. Most participants (84.4%) considered skin cancer a serious health issue, and 11.1% were uncertain.

When asked about specific risk factors, 71.1% were very aware of prolonged sun exposure as a risk factor. 73.3% were highly aware of UV radiation risks, and 15.6% were not aware.

Only 34.4% were very aware of family history as a risk factor, and 35.6% were unaware.

Regarding the light skin type, 57.8% were aware, and 17.8% were not aware.

Awareness of all risk factors was significantly higher among participants with university-level education (p < 0.001) (Table 2).

Table 2: Awareness of skin cancer, risk factors, and education-based differences among the participants (n=450).

A total of 44.4% reported never performing self-examinations for suspicious moles. Only 10% conducted exams every six months or less. Older individuals and those with higher education were significantly more likely to perform regular self-examinations (p < 0.001).

Regarding knowledge of the ABCDE criteria for identifying melanoma:

53.3% were unaware, and 46.7% were aware. Awareness was significantly higher among university-educated respondents (p < 0.001).

Regarding photoprotection practices, only 22.2% always applied sunscreen, and 17.8% reported never having used it. Among sunscreen users, 62.2% preferred SPF 50+, and 24.4% did not know the SPF level of their sunscreen.

Education level was significantly associated with both frequency of sunscreen use and SPF preference (p < 0.001).

Regarding UVA protection, 40.0% used sunscreen with UVA protection, and 44.4% were unsure.

Protective clothing was worn often or always by 60%, while none reported never using them. Seeking shade during peak sun hours (10:00 AM to 16:00 PM) was frequent (always or often) in 73.3% of the respondents (Table 3).

Table 3: Self-examination, knowledge of the ABCDE criteria, and photoprotection practices among the participants, stratified by education level and age group (n=450). p-values are shown for self-examination by education and age; other variables are descriptive.

DISCUSSION

This study aimed to evaluate the relationship between demographics and skin cancer awareness behaviors. Research published in the Journal of the American Academy of Dermatology [1] found that women are more likely than men to perceive skin cancer risk, be concerned about its consequences, and use sunscreen. As explained in the American Journal of Clinical Dermatology [2], this trend is influenced by differences in health beliefs and social norms that encourage greater accessibility and health-conscious behaviors among women.

Education level emerged as one of the strongest predictors of skin cancer awareness and sun protection behaviors in this study, consistent with existing research [3–5]. This highlights the need for tailored educational campaigns, especially for populations with lower educational attainment, to bridge gaps in knowledge and behavior.

While most respondents were aware of the risks, only a quarter regularly used sunscreen. A study published by Emily et al. [6] found that despite high awareness, regular sunscreen use remained low. Forgetfulness was the most common barrier reported by Diehl et al. [7], suggesting the need for behavioral nudges, like reminder apps, to improve adherence to photoprotection.

According to a study in the Journal of the American Academy of Dermatology [8], dermatologists strongly advocate for regular sunscreen use, actively recommending it to patients, family, and friends. Meanwhile, social media is emerging as an effective information source. A study by Niu et al. [9] demonstrated that platforms such as Instagram and TikTok are effective in communicating the risks and encouraging protective behaviors among the youth. These results were supported by the work of Heckman et al. [10], suggesting that digitally active interventions were effective in improving several skin cancer risk and skin cancer prevention behaviors compared to the basic intervention, especially improvement in sun protection, but not other behaviors.

The limitations of our study were mainly the cross-sectional nature of the survey and the limited demographic diversity. The study relied on self-reported data, without objective measures of behaviors. Further research with larger, more diverse samples is necessary to validate these findings and enhance generalizability.

CONCLUSION

The findings underscore the need for interventions, particularly for men, younger individuals, and those with lower education levels, to enhance skin cancer prevention and early detection. Addressing barriers such as forgetfulness and providing clear, accessible education could improve adherence. Future interventions should adopt a multi-channel approach, integrating digital tools, healthcare guidance, and community outreach to promote consistent sun safety behaviors.