Sun Protection Behaviors Research Articles

The risk information and skin-cancer education for undergraduate prevention (RISE-UP) study: Protocol for a trial of personalized sun protection interventions for skin cancer prevention among undergraduate students

BackgroundAddressing the increasing incidence of skin cancer among young adults is a priority. The objective of the Risk Information and Skin-cancer Education for Undergraduate Prevention (RISE-UP) study is to identify personalized intervention components to prevent sunburn, a clinically significant outcome highly associated with skin cancer, in college students. MethodsGuided by the Elaboration Likelihood Model, the study will use Multiphase Optimization Strategy (MOST) methodology to test three intervention components (ultraviolet photography, MC1R genetic testing, and action planning) each with two levels (yes v. no) in a full-factorial experiment to evaluate unique and combined effects of these components to improve outcomes over the longer-term, with seasonally timed follow-up. At-risk University of Utah students (N = 528) will be recruited. Eligibility criteria include self-reported sunburn or tanning in the past year, or not utilizing recommended sun protection. After baseline assessment, participants will be randomized to intervention group, stratified by sex. Assessments will be completed at (1) Baseline; (2) Intervention; (3) 1 month after intervention; (4) 4 months after intervention (the end of the first summer); and (5) 15 months after intervention (the end of the second summer). The primary outcome will be participants' self-reported number of sunburns. Secondary outcomes will include self-reported sun protection and tanning behaviors and, in a randomly selected subgroup, an objective measure of ultraviolet radiation (UVR) exposure. ConclusionThe RISE-UP study will determine the efficacy of different combinations of personalized skin cancer preventative interventions for young adults and determine the optimal combination of intervention components to prevent skin cancer.Clinical Trial Registration:NCT05634252

Assessment of sun protection factors in the Irish adult population following the SunSmart Campaign 2023.

SunSmart is the National Cancer Control Programme's annual skin cancer prevention awareness campaign. This study aimed to assess sun protection attitudes following the 2023 campaign, and compare findings to 2022. An online survey was conducted in September 2023, a repeat of the 2022 survey. Data were collated and analysed in Excel. In 2023, 48% (n=480) adults reported being sunburnt that summer. Younger adults were more likely than older adults to report sunburn (62% v 28% p<0.001). In assessing the "SunSmart 5s": 94% rated sunscreen, 88% rated shade, 84% rated hats, 71% rated long sleeves, and 70% rated sunglasses as important. Older adults were more likely than younger adults to rate each factor as important. A higher proportion reported each factor as important compared to 2022. Awareness of the campaign increased, 32% having heard of SunSmart, compared to 21% in 2022 (p<0.001). Awareness was higher in older adults (39% v 21% p<0.001), and in those who reported no sunburn (34% v 30% p=0.023). Awareness of SunSmart and perceived importance of the sun protection factors have improved since 2022, with perceived importance of the "SunSmart 5s" reasonably high. Reaching younger adults and improving their sun protection behaviours remain areas for progress.

Artificial intelligence-driven skin aging simulation as a novel skin cancer prevention.

Skin cancer, a prevalent cancer type among fair-skinned patients globally, poses a relevant public health concern due to rising incidence rates. Ultraviolet (UV) radiation poses a major risk factor for skin cancer. However intentional tanning associated with sunburns remains a common practice, notably among female adults Appropriate prevention campaigns targeting children and adolescents are needed to improve sun-protection behavior particularly in these age groups. The aim of our study is to investigate if an AI-based simulation of facial skin aging can enhance sun-protection behavior in female adults. In this single-center prospective observational pilot study at Department of Dermatology at the University Hospital of Basel, we took photographs of healthy young females' faces with a VISIA-CR camera (Canfield Scientific Inc., Parsippany, New Jersey, Version 8.2) between February to March 2021. Digital images were performed in three angles (straight, left 45°, right 45°). All participants received an AI-based simulation of their facial skin with continuous aging to 80 years. A newly created anonymous questionnaire capturing participants' sociodemographic data and also tanning and sun-protection behavior was completed in pre- and post-aging simulation. To observe long-term effects, a 2-year follow-up was conducted between March to April 2023. The 60 participants (mean age 23.6±2.5 years) evaluated the importance of sun-protection significantly higher after skin aging simulation with VISIA-CR camera (p&lt;0.0001; 95%-CI:8.2-8.8). Post-intervention, 91.7% (55/60) of the females were motivated to reduce UV exposure and to intensify UV protection in the future since the individual UV-dependent risk was perceived significantly higher (p&lt;0.001; 95%-CI: 5.9-6.7). At two-year follow-up, 96% (24/25) indicated persistent effort reducing UV exposure. The preference for SPF50+ sunscreen increased to 46.7% (28/65) directly after the skin-aging simulation and continued to rise up to 60.0% (15/25) after two years. Our data emphasize the potential of AI-assisted photo-aging interventions to enhance motivation for UV protection in the short and the long term We encourage that different age and gender groups are addressed in a personalized, generation-specific manner with the appropriate media and by considering the Hawthorne effect. Campaigns with visual AI support can improve the intent of cancer-preventative behavior.

Barriers and facilitators to skin cancer prevention among Hispanics: a qualitative study

BackgroundIn the past two decades, melanoma incidence among Hispanic people has risen greatly. This qualitative study explored Hispanic people’s perceived barriers and facilitators to skin cancer-related preventive behaviors.MethodsFive focus groups among Hispanic people (2 in Spanish and 3 in English; n = 34; 11 Spanish-preferring and 23 English-preferring) were conducted, where participants discussed their perceptions and behaviors relating to skin cancer, sun protection, and skin self-examination. Additionally, healthcare providers (n = 9) and Hispanic community leaders (n = 6) were recruited for individual interviews to complement the results of focus groups. A thematic analysis was conducted on all transcripts.ResultsPerceived barriers to sun protection included: 1) Low levels of knowledge and awareness/misperception; 2) low perceived importance or not a priority, 3) economic issues or limited access, 4) downsides/concerns about engaging in sun protection behaviors, and 5) Hispanic cultural norms (e.g., machismo). Facilitators to sun protection included: 1) relevance/care for family, 2) negative consequences of sun exposure, and 3) Hispanic cultural norms (e.g., familismo). Barriers to skin examination included: 1) low levels of knowledge and awareness, 2) lack of insurance coverage or access, and 3) difficulty or discomfort associated with practicing skin self-examination. Facilitators to skin examination included: 1) relevance/previous experience and 2) having insurance coverage or access.ConclusionsFuture interventions should focus on individual, community, and system-level strategies to address misperceptions in the Hispanic community, increase knowledge and awareness, address perceptions of cultures regarding skin cancer preventive activities, and emphasize the importance or priority of health issues related to skin cancer.

The impact of skin cancer education and skin self-examination on mothers’ sun protection behaviours: a randomised controlled trial

Background: Skin cancer is a serious disease that is now widespread, affecting many people globally. It has a high mortality rate both worldwide and in Türkiye. This study investigated the effect of educating parents of secondary school students about skin cancer, skin self-examination (SSE), and sun protection behaviors on their children’s sun protection behaviors. Methods: The study was conducted as a randomized controlled experimental study. The study sample consisted of 240 parents. Data were collected using an introductory information form, the skin cancer and sun knowledge scale (SCSKS), and the parental sun protection scale (PSPS). Results: After training, the number of parents in the experimental group who applied SSE to their children increased to 59.2% (p&lt;0.001). However, this rate was determined as 10.8% in the control group. Significant increases were observed in the total SCSKS score (16.02±3.64) and the sun protection (4.63±1.28), tanning (7.45±1.98), and skin cancer prevention (1.54±0.59) subdimensions in intervention group (p&lt;0.001). After training, a positive and significant difference was observed in the outcome for PSPS self-efficacy subdimension as well as for the sun avoidance scale- product usage expectations subdimension in the experimental group (p&lt;0.05). Conclusions: There was also an increase in the number of parents performing SSE on their children. Parents have an impact on their children’s health. Therefore, educating parents is critical both in terms of their own sun protection behaviors and for those of their children. It is recommended that intervention studies be conducted with larger sample groups.

Abstract C012: Evaluation of skin cancer screening education provided by dermatologists with The Sun Bus for medical students

Abstract Introduction: Medical student curriculum is lacking in standardized training of skills for conducting the skin cancer screening examination. Dermatology is not a standard clinical rotation during medical school, and many medical students do not have much exposure to the specialty of dermatology for hands-on training in skin examinations by dermatologists. We sought to create an event in conjunction with the Sun Bus that included education about dermatology and skin examination for medical students. Objectives We sought to assess how the effects on knowledge of dermatology and skin cancer prevention and screening among participating medical students changed from participating in the educational event. Methods: The Health Education and Awareness Team of Texas Tech University Health Sciences Center El Paso collaborated with The Sun Bus to organize a training event for medical students. During this event, students had the opportunity to listen to a panel about dermatology as well as the basics of skin cancer screening from working dermatologists. Students also received a brief training on skin cancer screening provided by The Sun Bus and conducted screenings alongside dermatologists during a free skin cancer screening event. Students completed voluntary pre-event and post-event surveys. Results The vast majority of students did not feel confident in their ability to screen for skin cancer prior to attending the event. This research showed improved student confidence in providing skin cancer screenings and identifying suspicious skin lesions from the intervention. Conclusion: Medical students lack standardized training in dermatology and in the dermatologic skin cancer screening examination. This student educational event represents a meaningful intervention that improved medical students’ confidence in providing skin cancer screenings and identifying suspicious skin lesions. Bibliography The Sun Bus. https://www.thesunbus.org/about-us Accessed 11 Dec 2023. Compres E, Holzem K, Ibler E, Bierman JA, Rademaker AW, Kundu RV. A Brief Dermatology Curriculum in Skin Cancer Detection and Prevention to Improve Medical Student Knowledge and Confidence. MedEdPORTAL. 2020;16:11049. Published 2020 Dec 29. doi:10.15766/mep_2374-8265.11049 Moore MM, Geller AC, Zhang Z, et al. Skin cancer examination teaching in US medical education. Arch Dermatol. 2006;142(4):439-444. doi:10.1001/archderm.142.4.439 Ivanov NN, Swan A, Guseman EH, Whipps J, Jensen LL, Beverly EA. Medical Students' Knowledge, Attitudes, and Behaviors With Regard to Skin Cancer and Sun-Protective Behaviors. J Am Osteopath Assoc. 2018;118(7):444-454. doi:10.7556/jaoa.2018.098 Ivanov NN, Swan A, Guseman EH, Whipps J, Jensen LL, Beverly EA. Medical Students' Knowledge, Attitudes, and Behaviors With Regard to Skin Cancer and Sun-Protective Behaviors. J Am Osteopath Assoc. 2018;118(7):444-454. doi:10.7556/jaoa.2018.098 Citation Format: Elian A. Martin Lopez, Hannah Riva, Shravya Kichena Kichena, Daniel Lovasz, Brian Kan, Tannis Hogg, Jessica Chacon. Evaluation of skin cancer screening education provided by dermatologists with The Sun Bus for medical students [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C012

Sun protection knowledge and behaviors of agricultural workers in Turkey: a cross-sectional study

BackgroundAgricultural workers are at risk of developing skin cancer due to prolonged exposure to the sun during their daily work. This study was conducted to determine sun protection knowledge and behaviours of agricultural workers in Turkey.MethodsThe cross-sectional study was conducted with 460 participants working in agriculture. The data were collected using a sociodemographic form, Skin Cancer and Sun Knowledge Scale and Sun Protection Behaviour Scale. The data were analysed using One Way ANOVA and Independent Samples t Test.ResultsParticipants mean total score on the Skin Cancer and Sun Knowledge Scale was 15.24 ± 2.47 (max-min 0–25) and the mean total score on the Sun Protection Behaviour Scale was 24.10 ± 4.46 (max-min 8–40). Statistically significant disparities were observed between the SCBS, SPBS and their sub-divisions along with the working period, age, marital status, gender, level of education, income status, skin type and agricultural working status of the participants (p < .05).ConclusionThe study found that people working in the agriculture had inadequate sun protection behaviours and knowledge. Based on the study’s results, it is proposed to create intervention programmes that specifically target single, male, middle-aged or older individuals with extended working hours and low levels of education and income.

Survey of Sun Exposure Levels, Sun Protection Behavior, and Skin Cancer Risk Awareness in Junior Tennis Players.

Despite a growing number of young adults developing skin cancers, little is known about the sun-protective behavior of high school athletes exposed to high levels of UV radiation, such as junior tennis players. To investigate the frequency and quality of their sun protective behaviors, a web-based, anonymous survey was conducted among tennis players at high school varsity matches and United States Tennis Association tournaments in Southern California. Although 92.6% of the 81 respondents indicated they play during peak sun intensity hours, 46.9% stated they do not regularly wear sunscreen, 27.2% do not routinely wear hats or visors, only 9.9% wear protective eyewear, and 4.9% wear UV-protective clothing; furthermore, 87.5% of junior tennis players stated they are not very familiar with skin cancer, but 73.8% would like to learn more about it. The results of this study demonstrate a lack of consistent sun protective behavior among junior tennis players, providing a rationale for the development of targeted educational campaigns to increase skin cancer risk awareness and more effective sun-protective behavior.

Designing a Culturally Relevant Digital Skin Cancer Prevention Intervention for Hispanic Individuals: Qualitative Exploration.

In the past 2 decades, melanoma incidence among Hispanic individuals has risen by 20%. The mortality rate of Hispanic individuals is higher than that for non-Hispanic White individuals. Skin cancer can largely be prevented with regular sun protection, and skin cancer outcomes can be improved through early detection, for example, by skin self-examination. Alarmingly, Hispanic individuals are less aware of the symptoms and harms of skin cancers, tend to have misperceptions regarding the risks and benefits of skin cancer prevention behaviors, and engage in less sun protection behaviors than non-Hispanic White individuals. This study aimed to use a community-engaged approach and conduct both group and individual interviews among Hispanic individuals and relevant key stakeholders to explore the potential design of a mobile-based skin cancer prevention intervention for Hispanic individuals. This study used a qualitative design (focus groups and individual interviews). Participants were recruited from local community organizations' social media, local events, and contact lists (eg, email). Zoom interviews were conducted to examine whether Hispanic individuals would be interested in a mobile-based skin cancer intervention and to explore their preferences and suggestions to inform skin cancer prevention intervention design. Five focus groups (2 in Spanish and 3 in English) among self-identified Hispanic individuals (n=34) and 15 semistructured, in-depth individual interviews among key stakeholders (health care providers and community leaders; eg, dermatologist, nurse practitioner, licensed social worker, and church leader) were conducted. The main themes and subthemes emerging from the group discussions and individual interviews were organized into the following categories: intervention platform, delivery frequency and format, message design, engagement plan, and activities. WhatsApp and Facebook were identified as suitable platforms for the intervention. Messages including short videos, visuals (eg, images and photographs), and simple texts messages were preferred. Recommendations for message design included personalized messages, personal stories and narratives, culturally relevant design (eg, incorporating family values), and community-trusted sources. Potential engagement and retention recommendations were also discussed. Additional details and exemplar quotes of each theme and subtheme are described. This study provides important insights and directions for the design of a mobile, digital skin cancer intervention to modify Hispanic individuals' sun protection and skin self-examination behaviors to help improve skin cancer outcomes. Insights gathered from community leaders and health care providers provided valuable additions to the community-derived data. Leveraging popular digital platforms among Hispanic individuals such as WhatsApp or Facebook could be a promising approach to skin cancer prevention. Recommendations from the community included the use of concise videos, illustrative images, clear text messages, tailored communications, narratives featuring personal experiences, designs that reflect cultural significance, and information from sources that are trusted by the community, which provided useful strategies for future intervention design among Hispanic individuals.

Low Sun Exposure Is Associated with Both Progressive-Onset and Relapse-Onset Multiple Sclerosis Risk: A Case-Control Study

Background: Sun exposure has consistently been associated with multiple sclerosis (MS) onset, but case samples are predominantly relapse-onset MS (ROMS), and risk estimates have rarely been reported separately for ROMS and progressive-onset MS (POMS). We aimed to determine whether sun exposure prior to disease onset was associated with POMS and whether the effect differed between POMS and ROMS. Methods: This nationwide case-control study included 153 POMS cases, 204 incident ROMS cases, and 558 community controls with data from two separate datasets: the PPMS Study (2015–2021) and the Ausimmune Study (2003–2006). Information on time spent in the sun before the first MS symptom, skin phenotype, and sun protection behavior was collected. Satellite data on ambient ultraviolet radiation (UVR) were used to calculate cumulative UVR dose. Unconditional logistic regression was used with adjustment for covariates. Results: There were consistent dose-response associations, with higher levels of UVR exposure associated with a reduced risk of POMS, both for leisure-time and occupational UVR from age 6 to symptom onset. Associations were overall stronger for POMS than ROMS. For example, cumulative leisure-time UVR dose (per 100 kJ/m2 increment) was associated with POMS (aOR 0.93, 95% CI: 0.91–0.95) and the association was slightly weaker for ROMS (aOR 0.96, 95% CI: 0.94–0.99) for age 6 to symptom onset (test for interaction p < 0.001). Conclusions: Low levels of sun exposure, throughout the whole lifespan, are associated with an increased risk of POMS and ROMS onset. The sun effects are usually stronger for POMS than ROMS.

The National Cancer Aid monitoring (NCAM-online) of ultraviolet radiation risk and protection behavior: a population-based observational trend study with four annual online survey waves

BackgroundUltraviolet (UV) radiation is the most important risk factor for skin cancer development. Sunlight is the main source of UV radiation in the general population. In addition, tanning beds are a source of artificial UV radiation. Since the incidence of skin cancer is increasing worldwide, it is necessary to monitor UV-related risk behaviors such as intentional indoor and outdoor tanning, as well as sun protection behavior in the general population and specific subgroups and settings. This is the aim of the National Cancer Aid Monitoring online (NCAM-online), a continuation and further development of the NCAM.MethodsThe NCAM-online is a longitudinal trend study consisting of four annual survey waves. Each year, 4,000 individuals aged 16–65 years living in Germany will be surveyed using online questionnaires. Each year, intentional indoor and outdoor tanning will be assessed. In addition, varying specific topics regarding skin cancer prevention, such as the utilization of skin cancer screening, will be addressed in the questionnaires.DiscussionThe findings of the NCAM-online will provide an important basis for the German Cancer Aid and Working Group on Dermatologic Prevention (Arbeitsgemeinschaft Dermatologische Prävention, ADP) to develop targeted prevention campaigns and projects aimed at preventing skin cancer. The explorative nature of the NCAM-online allows for the identification of new potential starting points for prevention and education. In addition, the longitudinal design allows for a description of the trend in the prevalence of intentional tanning. For tanning bed use, representative trend data from 2012 are available for Germany, to which NCAM-online will add annual data until 2027.

A Comprehensive Analysis of Skin Cancer Concerns and Protective Practices in Manitoba, Canada, Highlights Lack of Skin Cancer Awareness and Predominance of High-Risk Sun Exposure Behaviors.

The rapidly increasing skin cancer rates in Canada are alarming, with current data estimating that 1/3 of Canadians will be affected in their lifetime. Thus, deeper understanding of high-risk sun exposure behaviors is needed to help counter this trend. Only limited action has been taken by federal/provincial governments to reduce skin cancer incidence. A cross-sectional survey study was conducted in Manitoba, with frequency counts, means, and percentages used to encapsulate responses. Age- and gender-adjusted odds ratios were calculated using logistic regression analyses. Our study identified worrying inadequacies in sun protective behaviors and attitudes, with the threat of such high-risk behaviors amplified by a lack of skin cancer awareness. Alarming elements were noted in participants' sun exposure history (>65% reported a history of sunburns, >50% previously used a tanning bed, and >75% recently tanned for pleasure), beliefs and attitudes (>50% believe that they look better/healthier with a tan, and >40% believe that having a base tan is protective against further sun damage), and sun protection efforts (sun protective clothing was used <60% of the time, sunscreen was used by <50%, and there was a lack of knowledge about sunscreen characteristics in ~30% of respondents), in addition to significant differences being established between demographic subgroups (based on gender, age, skin phototype, income, and education attained). This study provides worrisome insight onto the grim landscape of sun protective behaviors and attitudes in Manitoba, which will inevitably translate into higher skin cancer rates and should serve as a call to action to promote targeted public health messaging in this jurisdiction and beyond.

How Does Illness Perception Affect the Quality of Life and Sun Protection Behaviors of Rosacea Patients?

Previous studies have noted the link between rosacea severity and quality of life, but there is limited understanding of how disease perception impacts these aspects. Additionally, sun exposure is identified as a common trigger for rosacea flare-ups, emphasizing the importance of sun protection practices in managing the condition. This cross-sectional study aims to fill the gap in the literature by investigating the relationship between clinical severity, disease perception, quality of life, and sun protection behaviors in rosacea patients. Questionnaires assessing the quality of life, illness perception, sun protection behaviors, sun protection decisional balance, and its potential predictors were completed by 120 rosacea patients and 120 controls. Patients exhibited a higher prevalence of sun protection behaviors than the control group (24.15 ± 5.76 vs. 17.63 ± 5.56, p < 0.001) and demonstrated greater determination in adhering to sun protection practices (13.43 ± 2.37 vs. 9.40 ± 3.09, p < 0.001). Hierarchical linear regression analyses showed that quality of life was related to clinical severity, illness perception (consequences, illness coherence, emotional representations), causal attribution (risk factors, immunity), and sun protection decisional balance variables (R2 = 0.45, F = 7.39, p < 0.001). Also, the perceived pros and cons of sun protection behaviors were predicted by illness perception (treatment control), causal attribution (risk factors, immunity, chance/accident), and quality of life variables (R2 = 0.24, F = 2.59, p = 0.004). Providing more information to rosacea patients can improve their disease perception and quality of life, increasing adherence to sun protection behaviors.

53267 Income-Related Disparities in Sunscreen Metabolite Concentrations: Insights into Sun Protection Behavior

53267 Income-Related Disparities in Sunscreen Metabolite Concentrations: Insights into Sun Protection Behavior

53420 Temporal Trends in Sun Protective Behaviors in Hispanic and Non-Hispanic White Individuals in the United States

53420 Temporal Trends in Sun Protective Behaviors in Hispanic and Non-Hispanic White Individuals in the United States

51892 A Comparative Study of Sun Protective Behaviors and Beliefs among Parents of Youth Athletes in Rural and Urban Ohio

51892 A Comparative Study of Sun Protective Behaviors and Beliefs among Parents of Youth Athletes in Rural and Urban Ohio

50709 Sun protective behaviors among patients at higher risk for melanoma

50709 Sun protective behaviors among patients at higher risk for melanoma

It's not just about the sun, it's about a living: Rural older farmers' experience of skin cancer risk and prevention.

To understand rural older farmers' perspectives and attitudes toward skin cancer risk and prevention. This study used a grounded theory approach and semi-structured interviews with 12 rural older farmers (farm owners, farmworkers ages 50 years or older) in Washington. Participants' perspectives were explored relative to Health Belief Model constructs. Inductive and deductive analyses were used to generate relevant themes. COREQ guidelines were followed. The findings fit well and extended the Health Belief Model, which was used to arrange key themes identified in relation to skin cancer risk and prevention, specifically participants' perceived barriers to accessing primary care and protection when outdoors, perceived benefits of sun-protective behaviors, perceived hereditary susceptibility to skin cancer, perceived severity of the increased skin cancer risk, and cues to action for skin checks. A new construct of hope was identified to emphasize the importance of establishing emotional, instrumental, and informational support systems for promoting skin cancer prevention. Participants also indicated their hope of raising awareness of skin cancer prevention among all ages. Findings highlighted the importance of integrating skin cancer prevention services for rural older farmers and across the lifespan. Public health approaches are needed to enhance the awareness of and access to preventive care in these underserved populations.

Sun protection behaviors among adult survivors receiving hematopoietic cell transplantation: a cross-sectional survey of a single institution in Japan

Sun protection behaviors among adult survivors receiving hematopoietic cell transplantation: a cross-sectional survey of a single institution in Japan

The Role of Health Literacy in Skin Cancer Preventative Behavior and Implications for Intervention: A Systematic Review.

Health literacy is essential for individuals to access, understand, and utilize information and services to inform health related decisions and actions. As one of the most diagnosed and preventable forms of cancer, skin cancer disease risk can be reduced through preventative behavior. Currently, there is no focused study looking specifically at health literacy and skin cancer. An understanding of how health literacy affects skin cancer-related preventive behaviors can improve current practices in skin cancer prevention. To systematically identify, synthesize, and summarize findings on the role of health literacy in skin cancers (including cutaneous squamous cell carcinoma, basal cell carcinoma, and melanoma), with a focus on preventive behaviors using studiesthat utilized quantifiablehealth literacy measurements. A literature search was performed by searching PubMed, Embase, PsycINFO, and CINAHL from inception until September 26, 2023 to identify cross-sectional, case-control, cohort, or randomized controlled studies that investigated the association between health literacy and skin cancer prevention and diagnosis. Health literacy levels varied across geographic regions, specific populations, and ethnicities. Most of the included studies found a positive association between higher health literacy and better skin cancer preventative behaviors. This included sun-protective behaviors such as: wearing sleeved shirts or shirts with collars, using gloves, covering head and face, limiting sun exposure, more sunscreen use, and less sunbathing or indoor tanning. Higher health literacy was associated with increased likelihood to engage in genetic testing and less family influence on health in one study which assessed determinants of interest in skin cancer genetic testing. Another study investigating family communication about skin cancer found that higher health literacy was associated with increased family communication regarding general cancer risk. One sun protection interventional education program was effective at increasing participants' knowledge, awareness of skin cancer risk, willingness to change sun protection, and use of sun protection, but results varied between ethnic groups. Skin cancer-related educational interventions can be effective in improving health literacy and potentially lessen the impact of skin cancer through positive behavior modification, early detection, and disease knowledge and awareness. Interventions need to be tailored to its target population to maximize effectiveness due to thevarying baseline of health literacy identified across different geographic and ethnic groups. Protocol Registration PROSPERO CRD42022340826.