Knowledge, perceptions and behaviours about skin cancer and sun protection among secondary school students from Central Italy

Background: Although sun exposure is a strong risk factor for skin cancer, tanning is very popular among adolescents. Awareness of skin cancer and sun exposure might influence sun protective behaviours in this population.

Objectives: To investigate the awareness of skin cancer and sun-safe practices among Italian adolescents.

Methods: A questionnaire about knowledge of skin cancer, perceived severity of sun rays/skin cancer and behaviour toward sun protection was administered to 1204 secondary school students. Predictors of these three components were assessed by case-control analyses considering different combinations of answers. Multiple logistic regression models were used to this scope.

Results: The majority of participants had heard of skin cancer in the past (97.0%), correctly identified possible causes (58.6%) and names (64.2%) of skin cancers and judged appropriately the perceived danger of sunrays (70.2%) and skin cancer (80.6%). Nonetheless, students' behaviour was poor: only 13.5% stated to always use sun-safe practices and 39.1% never used any. Independent predictors of proper knowledge were: Lyceum school, and family or TV/media as information source; of appropriate perceived severity: Lyceum school, a darker skin type, and dermatologists as information source; of acceptable behaviour: female sex, a darker skin type, and dermatologists or general practitioners (GPs) as information source.

Conclusions: Despite a fairly good knowledge about skin cancer and sun exposure, students' behaviour was unsatisfactory. Knowledge is not sufficient to produce a positive behaviour, as determinants of these two aspects are different. Dermatologists and GPs should be considered as key-figures for future multicomponent intervention strategies in this field.