Abstract
BackgroundIn Denmark, 16,500 cases of melanoma and keratinocyte cancers were registered in 2015, of which 90% could have been avoided by behavioral changes. We aimed to test novel interventions in a randomized design. The interventions targeted Danes going on vacation to high UVI destinations aiming to decrease sunburn by increasing use of sun protection to prevent skin cancer in the Danish population.MethodsWe report a randomized behavioral intervention during May-Dec 2018 with 1548 Danish adults on vacation in 2018 for a period of 1–3 weeks. The study population was population-based and aged 18–65 years. We tested two protection routines against minimal intervention control group (2-by2-factorial design): 1) Avoidance of the sun during peak hours and shade, use of the UV-index and planning of indoor/outdoor activity respectively and, 2) Coverage by increasing use of the hat advice and increasing sunscreen amount by application routine. Outcome was use of protection and sunburn.ResultsThere were no differences in sunburn prevalence between intervention and control groups. Protection routine 1 and 2 both increased the overall protection score compared to non-users. Protection routine 1 increased the reported use of shade and decreased time exposed in the sun. Protection routine 2 increased the use of hat and sunscreen amount.ConclusionSimple measures can help avoid the majority of one of the most widespread cancers worldwide. Vacations to high UVI destinations is a major influence on the annual Danish UV-exposure. We influenced travelers to protect themselves better and to increase sun protection behavior.
Highlights
Incidence of melanoma and keratinocyte skin cancer have increased for decades especially in Caucasian populations [1]
Vacations to high UV index (UVI) destinations is a major influence on the annual Danish UV-exposure
The Danish sun safety campaign previously achieved successful results including a decrease in the fraction of sunburn [15] and a decrease in use of sunbeds [16]; the fraction of sunburn in the population going on vacations to sunny destinations with high UVI was unchanged from 25% in 2008 to 27% in 2014 [17]
Summary
Incidence of melanoma and keratinocyte skin cancer have increased for decades especially in Caucasian populations [1]. The Danish Sun Safety Campaign communicates three sun protection messages to avoid skin cancer. They are all aiming to reduce exposure to UVR from the sun by applying: Shade, when the UVI reaches the daily maximum between 12 and 3 pm, sunhat (and clothes) and sunscreen for uncovered parts of the body. The Danish sun safety campaign previously achieved successful results including a decrease in the fraction of sunburn [15] and a decrease in use of sunbeds [16]; the fraction of sunburn in the population going on vacations to sunny destinations with high UVI was unchanged from 25% in 2008 to 27% in 2014 [17]. The interventions targeted Danes going on vacation to high UVI destinations aiming to decrease sunburn by increasing use of sun protection to prevent skin cancer in the Danish population
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