Copyright
©The Author(s) 2022.
World J Clin Oncol. Jul 24, 2022; 13(7): 587-598
Published online Jul 24, 2022. doi: 10.5306/wjco.v13.i7.587
Published online Jul 24, 2022. doi: 10.5306/wjco.v13.i7.587
Table 1 Demographic and clinical characteristics of 121 patients who were included in our study
| Patients with a PMH of MM, n = 26/121 (21.5%) | Patients with AMS, n = 47/121 (38.8%) | Control group, n = 48/121 (39.7%) | All participants, n = 121 | P value | |
| Mean age (± SD) | 45.65 (± 12.61) | 43.21 (± 12.61) | 43.67 (± 12.65) | 43.92 (± 12.55) | 0.88 |
| Gender, n (%) | 0.39 | ||||
| Male | 10/26 (38.5) | 25/47 (53.2) | 20/48 (41.7) | 55/121 (45.5) | |
| Female | 16/26 (61.5) | 22/47 (46.8) | 28/48 (58.3) | 66/121 (54.5) | |
| Employment Status, n (%) | 0.40 | ||||
| Student | 2/26 (7.7) | 3/47 (6.4) | 2/48 (4.2) | 7/121 (5.8) | |
| Employed | 16/26 (61.5) | 36/47 (76.6) | 33/48 (68.8) | 85/121 (70.2) | |
| Unemployed | 2/26 (7.7) | 4/47 (8.5) | 7/48 (14.6) | 13/121 (10.7) | |
| Retired | 5/26 (19.2) | 3/47 (6.4) | 3/48 (6.3) | 11/121 (9.1) | |
| Housewife | 1/26 (3.8) | 1/47 (2.1) | 3/48 (6.3) | 5/121 (4.1) | |
| Educational level, n (%) | 0.61 | ||||
| Elementary school | 9/26 (34.6) | 1/47 (2.1) | 3/48 (6.3) | 4/121 (3.3) | |
| High school | 0/26 (0) | 20/47 (42.6) | 21/48 (43.8) | 50/121 (41.3) | |
| Technical studies | 6/26 (23.1) | 8/47 (17) | 5/48 (10.4) | 19/121 (15.7) | |
| University level | 11/26 (42.3) | 18/47 (38.3) | 19/48 (39.6) | 48/121 (39.7) | |
| Fitzpatrick skin phototype, n (%) | 0.81 | ||||
| Skin type I (Always burns, does not tan) | 0/26 (0) | 2/47 (4.3) | 2/48 (4.2) | 4/121 (3.3) | |
| Skin type II (Burns easily, tans poorly) | 10/26 (38.5) | 14/47 (29.8) | 15/48 (31.3) | 39/121 (32.2) | |
| Skin type III (Tans after initial burn) | 14/26 (53.8) | 24/47 (51.1) | 22/48 (45.8) | 60/121 (49.6) | |
| Skin type IV (Burns minimally, tans easily) | 2/26 (7.7) | 7/47 (14.9) | 9/48 (18.8) | 18/121 (14.9) | |
| BMI (± SD) | 25.07 (± 4.06) | 26.92 (± 5.12) | 25.58 (± 5.20) | 25.99 (± 4.96) | 0.281 |
| Eye colour, n (%) | 0.466 | ||||
| Dark | 1/26 (3.8) | 2/47 (4.3) | 5/48 (10.4) | 8/121 (6.6) | |
| Brown | 16/26 (61.5) | 31/47 (66) | 31/48 (64.4) | 78/121 (64.5) | |
| Blue | 3/26 (11.5) | 9/47 (19.1) | 5/48 (10.4) | 17/121 (14) | |
| Green | 6/26 (23.1) | 5/47 (10.6) | 7/48 (14.6) | 18/121 (18) | |
| Natural hair color, n (%) | 0.649 | ||||
| Red | 0/26 (0) | 1/47 (2.1) | 0/48 (0) | 1/121 (0.8) | |
| Blond | 5/26 (19.2) | 6/47 (12.8) | 8/48 (16.7) | 19/121 (15.7) | |
| Brown | 16/26 (61.5) | 34/47 (72.3) | 28/48 (58.3) | 78/121 (64.5) | |
| Black | 5/26 (19.2) | 6/47 (12.8) | 12/48 (25) | 23/121 (19) | |
| Number of naevi, n (%) | 0.000 | ||||
| < 25 naevi | 9/26 (34.6) | 0/47 (0) | 23/48 (47.9) | 32/121 (26.4) | |
| 25-50 naevi | 8/26 (30.8) | 2/47 (4.3) | 12/48 (25) | 22/121 (18.2) | |
| 50-100 naevi | 3/26 (11.5) | 11/47 (23.4) | 7/48 (14.6) | 21/121 (17.4) | |
| 100 naevi | 6/26 (23.1) | 34/47 (72.3) | 6/48 (12.5) | 46/121 (38) | |
| Smoking status, n (%) | |||||
| Current smoker | 8/26 (30.8) | 15/47 (31.9) | 9/48 (18.8) | 32/121 (26.4) | 0.198 |
| No smoker | 15/26 (57.7) | 25/47 (53.2) | 28/48 (58.3) | 68/121 (56.2) | |
| Ex-smoker | 3/26 (11.5) | 7/47 (14.9) | 11/48 (22.9) | 21/121 (17.4) | |
| Sunburn before the age of 18, n (%) | 0.000 | ||||
| No | 9/26 (34.6) | 30/47 (63.8) | 40/48 (83.3) | 79/121 (65.3) | |
| Yes | 17/26 (65.4) | 17/47 (36.2) | 8/48 (16.7) | 42/121 (34.7) | |
| Leisure sun exposure, n (%) | 0.393 | ||||
| No | 17/26 (65.4) | 31/47 (66) | 38/48 (79.2) | 86/121 (71.1) | |
| Yes | 9/26 (34.6) | 16/47 (34) | 10/48 (20.8) | 35/121 (28.9) | |
| Occupational sun exposure, n (%) | 0.35 | ||||
| No | 19/26 (73.1) | 27/47 (57.4) | 30/48 (62.5) | 76/121 (62.8) | |
| Yes | 7/26 (26.9) | 20/47 (42.6) | 18/48 (37.5) | 45/121 (37.2) | |
| Significant time spent outdoors, n (%) | 0.356 | ||||
| No | 11/26 (42.3) | 24/47 (51.1) | 28/48 (58.3) | 63/121 (52.1) | |
| Yes | 15/26 (57.7) | 23/47 (48.9) | 20/48 (42.7) | 58/121 (47.9) | |
| Mean weeks of vacation spent before the age of 10 (± SD) | 7.35 ± 5.61 | 6.87 ± 5 | 7.42 ± 4.36 | 7.19 ± 4.86 | 0.7444 |
| Mean weeks of vacation spent before from the age of 11 till 18 (± SD) | 6.12 ± 4.27 | 6.38 ± 4.44 | 6.94 ± 4.20 | 6.55 ± 4.29 | 0.740 |
| Mean weeks of vacation spent after the age of 18 (± SD) | 3.92 ± 2.1 | 4.02 ± 2.77 | 4.98 ± 4.35 | 4.39 ± 3.40 | 0.806 |
Table 2 Sun protection practices in patients with malignant melanoma, those with atypical mole syndrome, and controls
| Patients with a PMH of MM, n = 26 | Patients with AMS, n = 47 | Control group, n = 48 | All participants, n = 121 | P value | |
| Do you use sunscreen? n (%) | |||||
| No | 5/26 (19.2) | 7/47 (14.9) | 5/48 (10.4) | 17/121(14) | 0.461 |
| Yes | 21/26 (80 .8) | 40/47 (85.1) | 43/48 (89.8) | 104/121 (86) | |
| If yes, which SPF sunblock rating do you use? n (%) | |||||
| < 30 | 2/26 (7.7) | 5/47 (10.6) | 9/48 (18.8) | 16/121 (13.2) | 0.222 |
| ≥ 30 | 7/26 (26.9) | 10/47 (21.3) | 14/48 (29.2) | 31/121 (25.6) | |
| ≥ 50 | 12/26 (46.2) | 25/47 (53.2) | 20/48 (41.7) | 57/121 (47.1) | |
| No sunscreen use | 5/26 (19.2) | 7/47 (14.9) | 5/48 (10.4) | 17/121 (14) | |
| How frequently do you use sunscreen? n (%) | |||||
| Everyday | 5/26 (19.2) | 6/47 (12.8) | 11/48 (22.9) | 22/121 (18.2) | 0.663 |
| Most days | 4/26 (15.4) | 13/47 (27.7) | 10/48 (20.8) | 27/121 (22.3) | |
| Occasionally | 11/26 (42.3) | 18/47 (38.3) | 18/48 (37.5) | 47/121 (38.8) | |
| Rarely | 1/26 (3.8) | 3/47 (6.4) | 4/48 (8.3) | 8/121 (6.6) | |
| No sunscreen use | 5/26 (19.2) | 7/47 (14.9) | 5/48 (10.4) | 17/121 (14) | |
| During which seasons do you apply sunscreen? n (%) | |||||
| Only during the summer | 17/26 (65.4) | 37/47 (78.7) | 30/48 (62.5) | 84/121 (69.4) | 0.353 |
| All year-round | 4/26 (15.4) | 3/47 (6.4) | 13/48 (27.1) | 20/121 (16.5) | |
| No sunscreen use | 5/26 (19.2) | 7/47 (14.9) | 5/48 (10.4) | 17/121 (14) | |
| In which of the following weather conditions do you apply sunscreen? n (%) | |||||
| Only in direct sunny weather | 17/26 (65.4) | 38/47 (80.9) | 34/48 (70.8) | 89/121 (73.6) | 0.606 |
| Both sunny and cloudy weather | 4/26 (15.4) | 2/47 (4.3) | 9/48 (18.8) | 15/121 (12.4) | |
| No sunscreen use | 5/26 (19.2) | 7/47 (14.9) | 5/48 (10.4) | 17/121 (14) | |
| While outdoors, do you reapply sunscreen? n (%) | |||||
| No | 16/26 (61.5) | 21/47 (44.7) | 33/48 (68.8) | 70/121 (57.9) | 0.31 |
| Yes | 10/26 (38.5) | 26/47 (55.3) | 15/48 (31.3) | 51/121 (42.1) | |
| Do you reapply sunscreen after swimming or perspiring heavily? n (%) | |||||
| No | 14/26 (53.8) | 20/47 (42.6) | 28/48 (58.3) | 62/121 (51.2) | 0.139 |
| Yes | 12/26 (46.2) | 27/47 (57.4) | 20/48 (41.7) | 59/121 (48.8 ) | |
| Wearing UV-protective sunglasses, n (%) | |||||
| Everyday | 13/26 (50) | 21/47 (44.7) | 12/48 (25) | 46/121 (38) | 0.303 |
| Most days | 5/26 (19.2) | 10/47 (21.3) | 16/48 (33.3) | 31/121 (25.6) | |
| Occasionally | 2/26 (7.7) | 7/47 (14.9) | 13/48 (27.1) | 22/121 (18.2) | |
| Rarely | 1/26 (3.8) | 4/47 (8.5) | 4/48 (8.3) | 9/121 (7.4) | |
| Never | 5/26 (19.2) | 5/47 (10.6) | 3/48 (6.3) | 13/121 (10.7) | |
| Wearing a broad-brimmed hat, n (%) | |||||
| Everyday | 5/26 (19.2) | 3/47 (6.4) | 3/48 (6.3) | 11/121 (9.1) | 0.535 |
| Most days | 1/26 (3.8) | 6/47 (12.8) | 6/48 (12.5) | 13/121 (10.7) | |
| Occasionally | 6/26 (23.1) | 14/47 (29.8) | 13/48 (27.1) | 33/121 (27.3) | |
| Rarely | 7/26 (26.9) | 13/47 (27.7) | 6/48 (12.5) | 26/121 (21.5) | |
| Never | 7/26 (26.9) | 11/47 (23.4) | 20/48 (41.7) | 38/121 (31.4) | |
| Wearing long-sleeved shirts or long plants made from tight fabric weave, n (%) | |||||
| Everyday | 1/26 (3.8) | 2/47 (4.3) | 1/48 (2.1) | 4/121 (3.3) | 0.275 |
| Most days | 4/26 (15.4) | 11/47 (23.4) | 9/48 (18.8) | 24/121 (19.8) | |
| Occasionally | 7/26 (26.9) | 13/47 (27.7) | 16/48 (33.3) | 36/121 (29.8) | |
| Rarely | 5/26 (19.2) | 11/47 (23.4) | 12/48 (25) | 28/121 (23.1) | |
| Never | 9/26 (34.6) | 10/47 (21.3) | 10/48 (20.8) | 29/121 (24) | |
| Avoiding the sun during hours of peak sunlight intensity (10:00 am to 16:00 pm), n (%) | |||||
| Everyday | 8/26 (30.8) | 9/47 (19.1) | 5/48 (10.4) | 22/121 (18.2) | 0.492 |
| Most days | 10/26 (38.5) | 20/47 (42.6) | 26/48 (54.2) | 56/121 (46.3) | |
| Occasionally | 4/26 (15.4) | 11/47 (23.4) | 13/48 (27.1) | 28/121 (23.1) | |
| Rarely | 4/26 (15.4) | 5/47 (10.6) | 0/48 (0) | 9/121 (7.4) | |
| Never | 0/26 (0) | 2/47 (4.3) | 4/48 (8.3) | 6/121 (5) |
Table 3 Sun protection education in patients with malignant melanoma, those with atypical mole syndrome, and controls
| Patients with a PMH of MM, n = 26 | Patients with AMS, n = 47 | Control group, n = 48 | All participants, n = 121 | P value | |
| Have you ever been given advice on how to protect your skin from sunlight? n (%) | |||||
| No | 6/26 (23.1) | 9/47 (19.1) | 16/48 (33.3) | 31/121 (25.6) | 0.59 |
| Yes | 20/26 (76.9) | 38/47 (80.9) | 32/48 (66.7) | 90/121 (74.4) | |
| Have you ever received sun protection education from a family doctor? n (%) | |||||
| No | 6/26 (23.1) | 11/47 (23.4) | 18/48 (37.5) | 35/121 (28.9) | 0.109 |
| Yes | 20/26 (76.9) | 36/47 (76.6) | 30/48 (62.5) | 86/121 (71.1) | |
| On how many occasions have you received sun protection education from a healthcare professional? n (%) | |||||
| Never | 5/26 (19.2) | 10/47 (21.3) | 14/48 (29.2) | 29/121 (24) | 0.316 |
| Once | 4/26 (15.4) | 5/47 (10.6) | 6/48 (12.5) | 15/121 (12.5) | |
| Twice | 3/26 (11.5) | 6/47 (12.8) | 8/48 (16.7) | 17/121 (14) | |
| 3 times | 4/26 (15.4) | 5/47 (10.6) | 6/48 (12.5) | 15/121 (12.5) | |
| 3 times | 10/26 (38.5) | 21/47 (44.7) | 14/48 (29.2) | 45/121 (37) | |
| Have you ever received sun protection education from Media (i.e., television, newspaper)? n (%) | |||||
| No | 11/26 (42.3) | 22/47 (46.8) | 25/48 (52.1) | 58/121 (47.9) | 0.546 |
| Yes | 15/26 (57.57) | 25/47 (53.2) | 23/48 (47.9) | 63/121 (52.1) | |
| Have you ever received written advice about sun protection? n (%) | |||||
| No | 21/26 (80.8) | 38/47 (80.9) | 45/48 (93.8) | 17/121 (14) | 0.055 |
| Yes | 5/26 (19.2) | 9/47 (19.1) | 3/48 (6.3) | 104/121 (86) | |
| Would you be interested in receiving education about sun protection? n (%) | |||||
| No | 4/26 (15.4) | 12/47 (25.5) | 17/48 (35.4) | 33/121 (27) | 0.619 |
| Yes | 22/26 (84.6) | 35/47 (74.5) | 31/48 (64.6) | 88/121 (73) | |
| Would you be interested in receiving photoprotection advice about sun protection from a healthcare worker? n (%) | |||||
| No | 4/26 (15.4) | 16/47 (34) | 17/48 (35.4) | 33/121 (27.3) | 0.154 |
| Yes | 22/26 (84.6) | 31/47 (66) | 31/48 (64.6) | 88/121 (72.7) | |
| Would you be interested in receiving photoprotection advice about sun protection from multimedia? n (%) | |||||
| No | 11/26 (42.3) | 16/41 (34) | 20/48 (41.7) | 47/121 (36.8) | 0.693 |
| Yes | 15/26 (57.7) | 31/41 (66) | 28/48 (58.3) | 74/121 (61.2) |
Table 4 Perceived barriers to implementation of photoprotection practices in patients with malignant melanoma, those with atypical mole syndrome, and controls
| Patients with a PMH of MM, n = 26 | Patients with AMS, n = 47 | Control group, n = 48 | All participants, n = 121 | P value | |
| Have any of the following barriers discouraged you from practicing sun protection? n (%) | |||||
| No | 7/26 (26.9%) | 27/47 (57.4%) | 24/48 (50%) | 58/121 (47.9%) | 0.656 |
| Yes | 19/26 (73.1%) | 20/47 (42.6%) | 24/48 (50%) | 63/121 (52.1%) | |
| Skepticism (“I do not believe skin cancer is a serious health threat”), n (%) | |||||
| No | 22/26 (84.6%) | 43/47 (91.5%) | 45/48 (93.8%) | 110/121 (90.9%) | 0568 |
| Yes | 4/26 (15.4%) | 4/47 (8.5%) | 3/48 (6.3%) | 11/121 (9.1%) | |
| Hassle/lack of time, n (%) | |||||
| No | 21/26 (80.8%) | 35/47 (74.5%) | 38/48 (79.2%) | 94/121 (77.7%) | 0.639 |
| Yes | 5/26 (19.2%) | 12/47 (25.5%) | 10/48 (20.8%) | 27/121 (22.3%) | |
| Concerns over adequate Vitamin D, n (%) | |||||
| No | 20/26 (76.9%) | 34/47 (72.3%) | 32/48 (66.7%) | 86/121 (71.1%) | 0.486 |
| Yes | 6/26 (23.1%) | 13/47 (27.7%) | 16/48 (33.3%) | 35/121 (28.9%) | |
| Cost/financial concerns. n (%) | |||||
| No | 25/26 (96.2%) | 38/47 (80.9%) | 39/48 (81.3%) | 102/121 (84.3%) | 0.810 |
| Yes | 1/26 (3.8%) | 9/47 (19.1%) | 9/48 (18.8%) | 19/121 (15.7%) | |
| Appearance (“I do not like how using sun protection will make me look”), n (%) | |||||
| No | 24/26 (92.3%) | 44/47 (93.6%) | 48/48 (100%) | 116/121 (95.9%) | 0.090 |
| Yes | 2/26 (7.7%) | 3/47 (6.4%) | 0/48 (0%) | 5/121 (4.1%) | |
| Difficulty obtaining materials (sunscreen, sunglasses, hats, etc), n (%) | |||||
| No | 25/26 (96.2%) | 44/47 (93.6%) | 114/121 (94.2%) | 0.962 | |
| Yes | 1/26 (3.8%) | 3/47 (6.4%) | 7/121 (5.8%) | ||
| Sunscreen is uncomfortable or unpleasant, n (%) | |||||
| No | 22/26 (84.6%) | 43/48 (91.5%) | 47/48 (97.9%) | 112/121 (93%) | 0.149 |
| Yes | 4/26 (15.4%) | 4/48 (8.5%) | 1/48 (2.1%) | 9/121 (7%) | |
| Previous “bad” reaction to sunscreen (please specify), n (%) | |||||
| No | 25/26 (96.2%) | 47/47 (100%) | 48/48 (100%) | 120/121 (99.2%) | 0.765 |
| Yes | 1/26 (3.8%) | 0/47 (0%) | 0/48 (0%) | 1/121 (0.8%) | |
| None/no barriers have discouraged me, n (%) | |||||
| No | 14/26 (53.8%) | 21/121 (44.7%) | 23/48 (47.9%) | 58/121 (47.9%) | 0.840 |
| Yes | 12/26 (46.2%) | 26/121 (55.3%) | 25/48 (52.1% | 63/121 (52.1%) |
- Citation: Koumaki D, Papadakis M, Kouloumvakou S, Krasagakis K. Awareness, knowledge, and attitudes towards sun protection among patients with melanoma and atypical mole syndrome. World J Clin Oncol 2022; 13(7): 587-598
- URL: https://www.wjgnet.com/2218-4333/full/v13/i7/587.htm
- DOI: https://dx.doi.org/10.5306/wjco.v13.i7.587