Abstract

The incidence of skin cancer is increasing worldwide, mostly because of increasing exposure to ultraviolet (UV) radiation from the sun. The Sun Exposure and Protection Index (SEPI) questionnaire, developed in Linköping and validated in Sweden and Australia, is used to map sun habits, sun protection behaviour, and readiness to increase sun protection. We sought to examine differences in sun habits or sun protection behaviour and propensity to increase sun protection, based on SEPI as related to self-estimated skin UV sensitivity according to the Fitzpatrick classification. The study population comprised students at Linköping University, who were asked to complete the SEPI questionnaire. We examined differences in sun habits and sun protection behaviour according to skin type and gender. Individuals with lower UV sensitivity had significantly riskier sun habits and sun protection behaviour and were significantly less likely to increase sun protection. Women spent significantly more time tanning than men, more time in the midday sun, used sunscreen more frequently, and were more likely to seek the shade for sun protection. Individuals with higher UV sensitivity were significantly more likely to increase sun protection; individuals with low UV sensitivity tended to have a riskier attitude to sunbathing. In conclusion, self-estimated skin type and gender are important factors influencing sun exposure habits and sun protection behaviour.

Highlights

  • The Sun Exposure and Protection Index (SEPI) questionnaire for scoring of sun habits and readiness to increase sun protection was recently developed and has been validated in two different ultraviolent radiation (UVR) environments (Sweden and Australia; Detert, Hedlund, Anderson, Rodvall, Whiteman, Festin, & Falk, 2015; Falk & Anderson, 2014)

  • We investigated whether there were any differences in sun habits, sun protection behaviour or propensity to increase sun protection, as assessed by SEPI, with regard to self-estimated skin UV sensitivity according to the Fitzpatrick classification

  • Previous studies observing the relationship between self-estimated skin type and sun habits have shown that a sensitive skin type appears to be associated with a higher level of sun avoidance and protection (Falk, 2011, 2014; Falk & Anderson, 2013)

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Summary

Introduction

The Sun Exposure and Protection Index (SEPI) questionnaire for scoring of sun habits and readiness to increase sun protection was recently developed and has been validated in two different ultraviolent radiation (UVR) environments (Sweden and Australia; Detert, Hedlund, Anderson, Rodvall, Whiteman, Festin, & Falk, 2015; Falk & Anderson, 2014). As the incidence of skin cancer has increased dramatically worldwide during the past decades (Erdei & Torres, 2010; Gruber & Armstrong, 2006; Lomas, LeonardiBee, & Bath-Hextall, 2012; Rigel, 2008; Stewart & Wild, 2014), there is a pressing need for increased preventive measures. This is true for malignant melanoma (MM), the most lethal type of skin cancer, and for non-melanoma skin cancer (NMSC). The change in sun-seeking behaviour to a great extent derives from the notion that tanned skin is more appealing and a sign of health and well-being, holidays in warm and sunny locations have become more common and affordable, tanning beds are more frequently used, and smaller clothing and swimwear in warm temperatures have become increasingly popular (Erdei & Torres, 2010; Lautenschlanger, Wulf, & Pittelkow, 2007; Norval, Lucas, Cullen, de Gruiji, Longstreth, Takizawa et al, 2011)

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