Abstract
BackgroundIn the light of increasing skin cancer incidences worldwide, preventive measures to promote sun protection in individuals with risky sun habits have continued relevance and importance.AimTo report the long-term effect of individualised sun protection advice given in primary health care (PHC), on sun habits and sun protection behaviour.Design & settingIn 2005, 309 PHC patients were enrolled in a randomised controlled study performed in a Swedish PHC setting.MethodAt baseline, the study participants completed a Likert scale-based questionnaire, mapping sun habits, propensity to increase sun protection, and attitudes towards sun exposure, followed by randomisation into three intervention groups, all receiving individualised sun protection advice: in Group 1 (n = 116) by means of a letter, and in Group 2 (n = 97) and 3 (n = 96) communicated personally by a GP. In Group 3, participants also underwent a skin ultraviolet-sensitivity phototest, with adjusted sun protection advice based on the result. A repeated questionnaire was administered after 3 and 10 years.ResultsStatistically significant declines were observed in all groups for sun exposure mean scores over time. When using a cumulative score, according to the Sun Exposure and Protection Index (SEPI), significantly greater decrease in SEPI mean score was observed in Groups 2 and 3 (GP), compared to Group 1 (letter); P<0.01. The addition of a phototest did not enhance the effect of the intervention.ConclusionIndividualised sun protection advice mediated verbally by the GP can lead to sustained improvement of sun protective behaviour.
Highlights
Increasing skin cancer incidence is associated with substantial patient suffering and healthcare costs worldwide,[1,2,3,4,5] emphasising the necessity of preventive measures directed towards the disease
Present knowledge relies on the reasoning that if sun protection advice is proven to lead to increased sun protection, and increased sun protection per se is known to be associated with a reduction in risk for developing skin cancer,[10,11,12] it is likely that measures efficient in promoting sun protection will reduce the likelihood of developing skin cancer in the future
Individualised sun protection advice based on their questionnaire responses was given, in varying form depending on group; in Group 1 by means of a letter, with standardised comments on skin type and sun exposure habits, and a summarised risk assessment with personally-adjusted advice, and in Groups 2 and 3 mediated verbally through a personal Groups and 3 (GP) consultation
Summary
Increasing skin cancer incidence is associated with substantial patient suffering and healthcare costs worldwide,[1,2,3,4,5] emphasising the necessity of preventive measures directed towards the disease. The role and effectiveness of interventions to promote sun avoidance and protection in order to prevent skin cancer have been studied and debated during recent decades. In the light of increasing skin cancer incidences worldwide, preventive measures to promote sun protection in individuals with risky sun habits have continued relevance and importance. Method: At baseline, the study participants completed a Likert scale-based questionnaire, mapping sun habits, propensity to increase sun protection, and attitudes towards sun exposure, followed by randomisation into three intervention groups, all receiving individualised sun protection advice: in Group 1 (n = 116) by means of a letter, and in Group 2 (n = 97) and 3 (n = 96) communicated personally by a GP. Conclusion: Individualised sun protection advice mediated verbally by the GP can lead to sustained improvement of sun protective behaviour
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