Skip to main content

Skin cancer-related prevention and screening behaviors: a review of the literature

Abstract

Primary prevention and early detection continue to be of paramount importance in addressing the public health threat of skin cancer. The aim of this systematic review was to provide a comprehensive overview of the prevalence and correlates of skin cancer-related health behaviors in the general population. To achieve this aim, 91 studies published in international peer-reviewed journals over the past three decades were reviewed and synthesized. Reported estimates of sunscreen use varied considerably across studies, ranging from 7 to 90%. According to self-report, between 23 and 61% of individuals engage in skin self-examination at least once per year, and the documented prevalence of annual clinical skin examination ranges from 8 to 21%. Adherence to sun protection and screening recommendations is associated with a range of factors, including: female gender, sun-sensitive phenotype, greater perceived risk of skin cancer, greater perceived benefits of sun protection or screening, and doctor recommendation for screening. The literature suggests that a large proportion of the general population engage in suboptimal levels of sun protection, although there is substantial variability in findings. The strongest recommendation to emerge from this review is a call for the development and widespread use of standardized measurement scales in future research, in addition to more studies with a population-based, multivariate design. It is also recommended that specific targeted interventions are developed to increase the prevalence of preventative and early intervention behaviors for the control of skin cancer.

This is a preview of subscription content, access via your institution.

References

  • Abroms, L., Jorgensen, C. M., Southwell, B. G., Geller, A. C., & Emmons, K. M. (2003). Gender differences in young adults’ beliefs about sunscreen use. Health Education & Behavior, 30, 29–43.

    Article  Google Scholar 

  • Aitken, J. F., Janda, M., Lowe, J. B., Elwood, M., Ring, I. T., Youl, P. H., et al. (2004). Prevalence of whole-body skin self-examination in a population at high risk for skin cancer (Australia). Cancer Causes and Control, 15, 453–463.

    PubMed  Article  Google Scholar 

  • Aitken, J. F., Youl, P. H., Janda, M., Lowe, J. B., Ring, I. T., & Elwood, M. (2006). Increase in skin cancer screening during a community-based randomized intervention trial. International Journal of Cancer, 118, 1010–1016.

    CAS  Article  Google Scholar 

  • American Cancer Society. (2007). Facts and figures 2007. Atlanta: American Cancer Society.

    Google Scholar 

  • Anderson, P. J., Lowe, J. B., Stanton, W. R., & Balanda, K. P. (1994). Skin cancer prevention: A link between primary prevention and early detection? Australian Journal of Public Health, 18, 417–420.

    PubMed  CAS  Google Scholar 

  • Australian Cancer Network. (2008). Clinical practice guidelines for the management of melanoma in Australia and New Zealand. Canberra: National Health and Medical Research Council (NHMRC).

    Google Scholar 

  • Autier, P. (2007). Sunscreen use and increased duration of intentional sun exposure: Still a burning issue. International Journal of Cancer, 121, 1–5.

    CAS  Article  Google Scholar 

  • Baade, P. D., Balanda, K. P., Stanton, W. R., Lowe, J. B., & Del Mar, C. B. (2005). Community perceptions of suspicious pigmented skin lesions: Are they accurate when compared to general practitioners? Cancer Detection and Prevention, 29, 267–275.

    PubMed  Article  Google Scholar 

  • Balanda, K. P., Lowe, J. B., Stanton, W. R., & Gillespie, A. M. (1994). Enhancing the early detection of melanoma within current guidelines. Australian Journal of Public Health, 18, 420–423.

    PubMed  CAS  Google Scholar 

  • Banks, B. A., Silverman, R. A., Schwartz, R. H., & Tunnessen, W. W., Jr. (1992). Attitudes of teenagers toward sun exposure and sunscreen use. Pediatrics, 89, 40–42.

    PubMed  CAS  Google Scholar 

  • Baron, R., & Byrne, D. (1997). Social psychology. Boston: Allyn and Bacon.

    Google Scholar 

  • Bergenmar, M., Tornberg, S., & Brandberg, Y. (1997). Factors related to non-attendance in a population based melanoma screening program. Psycho-Oncology, 6, 218–226.

    PubMed  CAS  Article  Google Scholar 

  • Berwick, M., Fine, J. A., & Bolognia, J. L. (1992). Sun exposure and sunscreen use following a community skin cancer screening. Preventive Medicine, 21, 302–310.

    PubMed  CAS  Article  Google Scholar 

  • Berwick, M., Begg, C. B., Fine, J., Roush, G. C., & Barnhill, R. L. (1996). Screening for cutaneous melanoma by skin self-examination. Journal of the National Cancer Institute, 88, 17–23.

    PubMed  CAS  Article  Google Scholar 

  • Boe, K., & Tillotson, E. (2006). Encouraging sun safety for children and adolescents. Journal School Nursing, 22, 136–141.

    Article  Google Scholar 

  • Boldeman, C., Jansson, B., Nilsson, B., & Ullen, H. (1997). Sunbed use in Swedish urban adolescents related to behavioral characteristics. Preventive Medicine, 26, 114–119.

    PubMed  CAS  Article  Google Scholar 

  • Boldeman, C., Branstrom, R., Dal, H., Kristjansson, S., Rodvall, Y., Jansson, B., et al. (2001). Tanning habits and sunburn in a Swedish population age 13–50 years. European Journal of Cancer, 37, 2441–2448.

    PubMed  CAS  Article  Google Scholar 

  • Bourke, J. F., Healsmith, M. F., & Graham-Brown, R. A. (1995). Melanoma awareness and sun exposure in Leicester. British Journal of Dermatology, 132, 251–256.

    PubMed  CAS  Article  Google Scholar 

  • Brandberg, Y., Bolund, C., Michelson, H., Mansson-Brahme, E., Ringborg, U., & Sjoden, P. (1993). Participation in public screening for melanoma. European Journal of Cancer, 29, 860–863.

    Article  Google Scholar 

  • Brandberg, Y., Bolund, C., Michelson, H., Mansson-Brahme, E., Ringborg, U., & Sjoden, P. O. (1996). Perceived susceptibility to and knowledge of malignant melanoma: Screening participants vs the general population. Preventive Medicine, 25, 170–177.

    PubMed  CAS  Article  Google Scholar 

  • Brandberg, Y., Ullen, H., Sjoberg, L., & Holm, L. E. (1998). Sunbathing and sunbed use related to self-image in a randomized sample of Swedish adolescents. European Journal of Cancer Prevention, 7, 321–329.

    PubMed  CAS  Article  Google Scholar 

  • Branstrom, R., Brandberg, Y., Holm, L., Sjoberg, L., & Ullen, H. (2001). Beliefs, knowledge and attitudes as predictors of sunbathing habits and use of sun protection among Swedish adolescents. European Journal of Cancer Prevention, 10, 337–345.

    PubMed  CAS  Article  Google Scholar 

  • Branstrom, R., Hedblad, M. A., Krakau, I., & Ullen, H. (2002). Laypersons’ perceptual discrimination of pigmented skin lesions. Journal of the American Academy of Dermatology, 46, 667–673.

    PubMed  Article  Google Scholar 

  • Branstrom, R., Ullen, H., & Brandberg, Y. (2004). Attitudes, subjective norms and perception of behavioural control as predictors of sun-related behaviour in Swedish adults. Preventive Medicine, 39, 992–999.

    PubMed  Article  Google Scholar 

  • Call, T. R., Boucher, K. M., Whiting, B. L., Hart, M., Newman, K., Kinney, A. Y., et al. (2004). Motivating factors for attendance of skin cancer screenings. Journal of the American Academy of Dermatology, 51, 642–644.

    PubMed  Article  Google Scholar 

  • Campbell, H. S., & Birdsell, J. M. (1994). Knowledge, beliefs, and sun protection behaviors of Alberta adults. Preventive Medicine, 23, 160–166.

    PubMed  CAS  Article  Google Scholar 

  • Cancer Society of New Zealand. (2007). Position statement on skin cancer and early detection. Available at http://www.cancernz.org.nz/uploads/CSNZ_PS_Skin.pdf.

  • Carmel, S., Shani, E., & Rosenberg, L. (1994). The role of age and an expanded Health Belief Model in predicting skin cancer protective behavior. Health Education Research, 9, 433–447.

    PubMed  CAS  Article  Google Scholar 

  • Carriere, P., Baade, P., Newman, B., Aitken, J., & Janda, M. (2007). Cancer screening in Queensland men. Medical Journal of Australia, 186, 404–407.

    PubMed  Google Scholar 

  • Clarke, V., Williams, T., & Arthey, S. (1997). Skin type and optimistic bias in relation to the sun protection and suntanning behaviors of young adults. Journal of Behavioral Medicine, 20, 207–222.

    PubMed  CAS  Article  Google Scholar 

  • Cockburn, J., Hennrikus, D., Scott, R., & Sanson-Fisher, R. (1989). Adolescent use of sun-protection measures. Medical Journal of Australia, 151, 136–140.

    PubMed  CAS  Google Scholar 

  • Cody, R., & Lee, C. (1990). Behaviors, beliefs, and intentions in skin cancer prevention. Journal of Behavioral Medicine, 13, 373–389.

    PubMed  CAS  Article  Google Scholar 

  • Cokkinides, V. E., Johnston-Davis, K., Weinstock, M., O’Connell, M. C., Kalsbeek, W., Thun, M. J., et al. (2001). Sun exposure and sun-protection behaviors and attitudes among U.S. youth, 11 to 18 years of age. Preventive Medicine, 33, 141–151.

    PubMed  CAS  Article  Google Scholar 

  • Cook, D. J., Mulrow, C. D., & Haynes, R. B. (1997). Systematic reviews: Synthesis of best evidence for clinical decisions. Annals of Internal Medicine, 126, 376–380.

    PubMed  CAS  Google Scholar 

  • de Rooij, M. J., Rampen, F. H., Schouten, L. J., & Neumann, H. A. (1997). Factors influencing participation among melanoma screening attenders. Acta Dermato Venereologica, 77, 467–470.

    PubMed  Google Scholar 

  • Devos, S. A., Baeyens, K., & Van Hecke, L. (2003). Sunscreen use and skin protection behavior on the Belgian beach. International Journal of Dermatology, 42, 352–356.

    PubMed  Article  Google Scholar 

  • Dixon, H., Borland, R., & Hill, D. (1999). Sun protection and sunburn in primary school children: The influence of age, gender, and coloring. Preventive Medicine, 28, 119–130.

    PubMed  CAS  Article  Google Scholar 

  • Dobbinson, S., Wakefield, M., Hill, D., Girgis, A., Aitken, J. F., Beckmann, K., et al. (2008). Prevalence and determinants of Australian adolescents’ and adults’ weekend sun protection and sunburn, summer 2003–2004. Journal of the American Academy of Dermatology, 59, 602–614.

    PubMed  Article  Google Scholar 

  • Douglass, H. M., McGee, R., & Williams, S. (1997). Sun behaviour and perceptions of risk for melanoma among 21-year-old New Zealanders. Australian and New Zealand Journal of Public Health, 21, 329–334.

    PubMed  CAS  Article  Google Scholar 

  • Douglass, H. M., McGee, R., & Williams, S. (1998). Are young adults checking their skin for melanoma? Australian and New Zealand Journal of Public Health, 22, 562–567.

    PubMed  CAS  Article  Google Scholar 

  • Ermertcan, A. T., Ozturkcan, S., Dinc, G., Yurtman, D., Pala, T., & Sahin, M. T. (2005). Sunscreen use and sun protection practices in students and personnel of Celal Bayar University. Photodermatology, Photoimmunology and Photomedicine, 21, 191–197.

    PubMed  Article  Google Scholar 

  • Evans, A. M., Love, R. R., Meyerowitz, B. E., Leventhal, H., & Nerenz, D. R. (1985). Factors associated with active participation in a cancer prevention clinic. Preventive Medicine, 14, 358–371.

    PubMed  CAS  Article  Google Scholar 

  • Festinger, L. (1962). A theory of cognitive dissonance. Oxford: Stanford University Press.

    Google Scholar 

  • Foot, G., Girgis, A., Boyle, C., & Sanson-Fisher, R. (1993). Solar protection behaviours: A study of beachgoers. Australian Journal of Public Health, 17, 209–214.

    PubMed  CAS  Google Scholar 

  • Friedman, L., Bruce, S., Webb, J., Weinberg, A., & Cooper, H. (1993). Skin self-examination in a population at increased risk for skin cancer. American Journal of Preventive Medicine, 9, 359–364.

    PubMed  CAS  Google Scholar 

  • Fritschi, L., Green, A., & Solomon, P. (1992). Sun exposure in Australian adolescents. Journal of the American Academy of Dermatology, 27, 25–28.

    PubMed  CAS  Article  Google Scholar 

  • Garbe, C., & Buettner, P. G. (2000). Predictors of the use of sunscreen in dermatological patients in Central Europe. Preventive Medicine, 31, 134–139.

    PubMed  CAS  Article  Google Scholar 

  • Geller, A. C., Colditz, G., Oliveria, S., Emmons, K., Jorgensen, C., Aweh, G. N., et al. (2002). Use of sunscreen, sunburning rates, and tanning bed use among more than 10,000 US children and adolescents. Pediatrics, 109, 1009–1014.

    PubMed  Article  Google Scholar 

  • Geller, A. C., Zhang, Z., Sober, A. J., Halpern, A. C., Weinstock, M. A., Daniels, S., et al. (2003). The first 15 years of the American Academy of Dermatology skin cancer screening programs: 1985–1999. Journal of the American Academy of Dermatology, 48, 34–41.

    PubMed  Article  Google Scholar 

  • Girgis, A., Campbell, E., Redman, S., & Sanson-Fisher, R. (1991). Screening for melanoma: A community survey of prevalence and predictors. Medical Journal of Australia, 154, 338–343.

    PubMed  CAS  Google Scholar 

  • Glanz, K., Lew, R., Song, V., & Cook, V. (1999). Factors associated with skin cancer prevention practices in a multiethnic population. Health Education and Behavior, 26, 344–359.

    PubMed  CAS  Article  Google Scholar 

  • Glanz, K., Yaroch, A., Dancel, M., Saraiya, M., Crane, L., Buller, D., et al. (2008). Measures of sun exposure and sun protection practices for behavioral and epidemiologic research. Archives of Dermatology, 144, 217–222.

    PubMed  Article  Google Scholar 

  • Guile, K., & Nicholson, S. (2004). Does knowledge influence melanoma-prone behavior? Awareness, exposure, and sun protection among five social groups. Oncology Nursing Forum, 31, 641–646.

    PubMed  Article  Google Scholar 

  • Hall, H. I., May, D. S., Lew, R. A., Koh, H. K., & Nadel, M. (1997). Sun protection behaviors of the U.S. white population. Preventive Medicine, 26, 401–407.

    PubMed  CAS  Article  Google Scholar 

  • Hall, H. I., McDavid, K., Jorgensen, C. M., & Kraft, J. M. (2001). Factors associated with sunburn in white children aged 6 months to 11 years. American Journal of Preventive Medicine, 20, 9–14.

    PubMed  CAS  Article  Google Scholar 

  • Hall, H., Saraiya, M., Thompson, T., Hartman, A., Glanz, K., & Rimer, B. (2003). Correlates of sunburn experiences among U.S. adults: Results of the 2000. National Health Interview Survey. Public Health Reports, 118, 540–549.

    PubMed  Google Scholar 

  • Hanrahan, P. F., Hersey, P., & D’Este, C. A. (1998). Factors involved in presentation of older people with thick melanoma. Medical Journal of Australia, 169, 410–414.

    PubMed  CAS  Google Scholar 

  • Hart, K., & DeMarco, R. (2008). Primary prevention of skin cancer in children and adolescents: A review of the literature. Journal of Pediatric Oncology Nursing, 25, 67–78.

    PubMed  Article  Google Scholar 

  • Harth, Y., Ulman, Y., Peled, I., & Friedman-Birnbaum, R. (1995). Sun protection and sunscreen use after surgical treatment of basal cell carcinoma. Photodermatology, Photoimmunology and Photomedicine, 11, 140–142.

    PubMed  CAS  Google Scholar 

  • Hill, D., Rassaby, J., & Gardner, G. (1984). Determinants of intentions to take precautions against skin cancer. Community Health Studies, 8, 33–44.

    PubMed  CAS  Google Scholar 

  • Hill, D., White, V., Borland, R., & Cockburn, J. (1991). Cancer-related beliefs and behaviours in Australia. Australian Journal of Public Health, 15, 14–23.

    PubMed  CAS  Google Scholar 

  • Hill, D., White, V., Marks, R., Theobald, T., Borland, R., & Roy, C. (1992). Melanoma prevention: Behavioral and nonbehavioral factors in sunburn among an Australian urban population. Preventive Medicine, 21, 654–669.

    PubMed  CAS  Article  Google Scholar 

  • Hillhouse, J. J., Stair, A. W., I. I. I., & Adler, C. M. (1996). Predictors of sunbathing and sunscreen use in college undergraduates. Journal of Behavioral Medicine, 19, 543–561.

    PubMed  CAS  Article  Google Scholar 

  • Hoegh, H., Davis, B., & Manthe, A. (1999). Sun avoidance practices among non-hispanic white Californians. Health Education and Behavior, 26, 360–368.

    PubMed  CAS  Article  Google Scholar 

  • Hourani, L., & LaFleur, B. (1995). Predictors of gender differences in sun-screen use and screening outcome among skin cancer screening participants. Journal of Behavioral Medicine, 18, 461–477.

    PubMed  CAS  Article  Google Scholar 

  • Jackson, K., & Aiken, L. (2000). A psychosocial model of sun protection and sunbathing in young women: The impact of health beliefs, attitudes, norms, and self-efficacy for sun protection. Health Psychology, 19, 469–478.

    PubMed  CAS  Article  Google Scholar 

  • Janda, M., Elwood, M., Ring, I. T., Firman, D. W., Lowe, J. B., Youl, P. H., et al. (2004a). Prevalence of skin screening by general practitioners in regional Queensland. Medical Journal of Australia, 180, 10–15.

    PubMed  Google Scholar 

  • Janda, M., Youl, P. H., Lowe, J. B., Elwood, M., Ring, I. T., & Aitken, J. F. (2004b). Attitudes and intentions in relation to skin checks for early signs of skin cancer. Preventive Medicine, 39, 11–18.

    PubMed  Article  Google Scholar 

  • Janz, N., & Becker, M. (1984). The Health Belief Model: A decade later. Health Education Quarterly, 11, 1–47.

    PubMed  CAS  Google Scholar 

  • Jemal, A., Devesa, S. S., Fears, T. R., & Hartge, P. (2000). Cancer surveillance series: changing patterns of cutaneous malignant melanoma mortality rates among whites in the United States. Journal of the National Cancer Institute, 92, 811–818.

    PubMed  CAS  Article  Google Scholar 

  • Jemal, A., Devesa, S. S., Hartge, P., & Tucker, M. A. (2001). Recent trends in cutaneous melanoma incidence among whites in the United States. Journal of the National Cancer Institute, 93, 678–683.

    PubMed  CAS  Article  Google Scholar 

  • Jones, F., Harris, P., & Chrispin, C. (2000). Catching the sun: An investigation of sun-exposure and skin protective behaviour. Psychology Health & Medicine, 5, 131–141.

    Article  Google Scholar 

  • Keesling, B., & Friedman, H. (1987). Psychosocial factors in sunbathing and sunscreen use. Health Psychology, 6, 477–493.

    PubMed  CAS  Article  Google Scholar 

  • Koh, H. K., Geller, A. C., Miller, D. R., Caruso, A., Gage, I., & Lew, R. A. (1991). Who is being screened for melanoma/skin cancer? Characteristics of persons screened in Massachusetts. Journal of the American Academy of Dermatology, 24, 271–277.

    PubMed  CAS  Article  Google Scholar 

  • Koh, H., Bak, S., Geller, A., Mangione, T., Hingson, R., Levenson, S., et al. (1997). Sunbathing habits and sunscreen use among white adults: Results of a national survey. American Journal of Public Health, 87, 1214–1217.

    PubMed  CAS  Article  Google Scholar 

  • Lamanna, L. (2004). College students’ knowledge and attitudes about cancer and perceived risks of developing skin cancer. Dermatology Nursing, 16, 161–176.

    PubMed  Google Scholar 

  • Leary, M., & Jones, J. (1993). The social psychology of tanning and sunscreen use: Self-presentational motives as a predictor of health risk. Journal of Applied Social Psychology, 23, 1390–1406.

    Article  Google Scholar 

  • LeBlanc, W. G., Vidal, L., Kirsner, R. S., Lee, D. J., Caban-Martinez, A. J., McCollister, K. E., et al. (2008). Reported skin cancer screening of US adult workers. Journal of the American Academy of Dermatology, 59, 55–63.

    PubMed  Article  Google Scholar 

  • Lewis, E., Mayer, J., & Slymen, D. (2006). Postal workers’ occupational and leisure-time sun safety behaviours (United States). Cancer Causes and Control, 17, 181–186.

    PubMed  Article  Google Scholar 

  • Livingston, P., White, V., Ugoni, A., & Borland, R. (2001). Knowledge, attitudes, and self-care practices related to sun protection among secondary students in Australia. Health Education Research, 16, 269–278.

    PubMed  CAS  Article  Google Scholar 

  • Lowe, J. B., Balanda, K. P., Gillespie, A. M., Del Mar, C. B., & Gentle, A. F. (1993). Sun-related attitudes and beliefs among Queensland school children: The role of gender and age. Australian Journal of Public Health, 17, 202–208.

    PubMed  CAS  Google Scholar 

  • Lower, T., Girgis, A., & Sanson-Fisher, R. (1998). The prevalence and predictors of solar protection use among adolescents. Preventive Medicine, 27, 391–399.

    PubMed  CAS  Article  Google Scholar 

  • Lucci, A., Watts Citro, H., & Wilson, L. (2001). Assessment of knowledge of melanoma risk factors, prevention, and detection principles in Texas teenagers. Journal of Surgical Research, 97, 179–183.

    PubMed  CAS  Article  Google Scholar 

  • MacKie, R. M., McHenry, P., & Hole, D. (1993). Accelerated detection with prospective surveillance for cutaneous malignant melanoma in high-risk groups. Lancet, 341, 1618–1620.

    PubMed  CAS  Article  Google Scholar 

  • Maddock, J. E., O’Riordan, D. L., Lunde, K. B., & Steffen, A. (2007). Sun protection practices of beachgoers using a reliable observational measure. Annals of Behavioral Medicine, 34, 100–103.

    PubMed  Article  Google Scholar 

  • Mahler, H. I., Kulik, J. A., Gibbons, F. X., Gerrard, M., & Harrell, J. (2003). Effects of appearance-based interventions on sun protection intentions and self-reported behaviors. Health Psychology, 22, 199–209.

    PubMed  Article  Google Scholar 

  • Marks, R. (1999). Two decades of the public health approach to skin cancer control in Australia: Why, how and where are we now? Australasian Journal of Dermatology, 40, 1–5.

    PubMed  CAS  Article  Google Scholar 

  • Marks, R. (2004). Campaigning for melanoma prevention: A model for a health education program. European Academy of Dermatology and Venereology, 18, 44–47.

    Article  Google Scholar 

  • Martin, R. H. (1995). Relationship between risk factors, knowledge and preventive behaviour relevant to skin cancer in general practice patients in South Australia. British Journal of General Practice, 45, 365–367.

    PubMed  CAS  Google Scholar 

  • Masri, G. D., Clark, W. H., Jr., Guerry, D., I. V., Halpern, A., Thompson, C. J., & Elder, D. E. (1990). Screening and surveillance of patients at high risk for malignant melanoma result in detection of earlier disease. Journal of the American Academy of Dermatology, 22, 1042–1048.

    PubMed  CAS  Article  Google Scholar 

  • McGee, R., & Williams, S. (1992). Adolescence and sun protection. New Zealand Medical Journal, 105, 401–403.

    PubMed  CAS  Google Scholar 

  • McGee, R., Elwood, M., Williams, S., & Lowry, F. (1994). Who comes to skin checks? New Zealand Medical Journal, 107, 58–60.

    PubMed  CAS  Google Scholar 

  • McPherson, M., Elwood, M., English, D. R., Baade, P. D., Youl, P. H., & Aitken, J. F. (2006). Presentation and detection of invasive melanoma in a high-risk population. Journal of the American Academy of Dermatology, 54, 783–792.

    PubMed  Article  Google Scholar 

  • Meiser, B., Cowan, R., Costello, A., Giles, G., Lindeman, G., & Gaff, C. (2007). Prostate cancer screening uptake amongst men with a family history of prostate cancer. Urology, 70, 738–742.

    PubMed  Article  Google Scholar 

  • Melia, J., & Bulman, A. (1995). Sunburn and tanning in a British population. Journal of Public Health Medicine, 17, 223–229.

    PubMed  CAS  Google Scholar 

  • Melia, J., Harland, C., Moss, S., Eiser, J. R., & Pendry, L. (2000). Feasibility of targeted early detection for melanoma: A population-based screening study. British Journal of Cancer, 82, 1605–1609.

    PubMed  CAS  Article  Google Scholar 

  • Mermelstein, R., & Riesenberg, L. (1992). Changing knowledge and attitudes about skin cancer risk factors in adolescents. Health Psychology, 11, 371–376.

    PubMed  CAS  Article  Google Scholar 

  • Michielutte, R., Dignan, M. B., Sharp, P. C., Boxley, J., & Wells, H. B. (1996). Skin cancer prevention and early detection practices in a sample of rural women. Preventive Medicine, 25, 673–683.

    PubMed  CAS  Article  Google Scholar 

  • Miller, D. R., Geller, A. C., Wyatt, S. W., Halpern, A., Howell, J. B., Cockerell, C., et al. (1996). Melanoma awareness and self-examination practices: Results of a United States survey. Journal of the American Academy of Dermatology, 34, 962–970.

    PubMed  CAS  Article  Google Scholar 

  • Monfrecola, G., Fabbrocini, G., Posteraro, G., & Pini, D. (2000). What do young people think about the dangers of sunbathing, skin cancer and sunbeds? A questionnaire survey among Italians. Photodermatology, Photoimmunology and Photomedicine, 16, 15–18.

    PubMed  CAS  Article  Google Scholar 

  • Moore, S. M., & Rosenthal, D. A. (1992). Australian adolescents’ perceptions of health-related risks. Journal of Adolescent Research, 7, 177–191.

    Article  Google Scholar 

  • Mullen, P. B., Gardiner, J. C., Rosenman, K., Zhu, Z., & Swanson, G. M. (1996). Skin cancer prevention and detection practices in a Michigan farm population following an educational intervention. Journal of Rural Health, 12, 311–320.

    Article  Google Scholar 

  • National Health & Medical Research Council (NHMRC) National Breast Cancer Centre Psychosocial Working Group. (2000). Psychosocial clinical practice guidelines: Providing information, support, and counselling for women with breast cancer. Canberra: Commonwealth of Australia.

    Google Scholar 

  • Newman, W. G., Agro, A. D., Woodruff, S. I., & Mayer, J. A. (1996). A survey of recreational sun exposure of residents of San Diego, California. American Journal of Preventive Medicine, 12, 186–194.

    PubMed  CAS  Google Scholar 

  • NHS Centre for Reviews and Dissemination. (2001). Undertaking systematic reviews of research on effectiveness: CRD’s guidance for those carrying out or commissioning reviews. York: University of York.

    Google Scholar 

  • Oliveria, S. A., Christos, P. J., Halpern, A. C., Fine, J. A., Barnhill, R. L., & Berwick, M. (1999). Evaluation of factors associated with skin self-examination. Cancer Epidemiology, Biomarkers and Prevention, 8, 971–978.

    PubMed  CAS  Google Scholar 

  • Parkin, D., Bray, F., Ferlay, J., & Pisani, P. (2005). Global cancer statistics, 2002. CA: A Cancer Journal for Clinicians, 55, 74–108.

    Article  Google Scholar 

  • Pincus, M. W., Rollings, P. K., Craft, A. B., & Green, A. (1991). Sunscreen use on Queensland beaches. Australasian Journal of Dermatology, 32, 21–25.

    PubMed  CAS  Article  Google Scholar 

  • Pruim, B., Wright, L., & Green, A. (1999). Do people who apply sunscreens, re-apply them? Australasian Journal of Dermatology, 40, 79–82.

    PubMed  CAS  Article  Google Scholar 

  • Purdue, M. P. (2002). Predictors of sun protection in Canadian adults. Canadian Journal of Public Health, 93, 470–474.

    Google Scholar 

  • Radius, S. M., Dillman, T. E., Becker, M. H., Rosenstock, I. M., & Horvath, W. J. (1980). Adolescent perspectives of health and illness. Adolescence, 15, 375–384.

    PubMed  CAS  Google Scholar 

  • Rampen, F. H., Berretty, P. J., Van Huystee, B. E., Kiemeney, L. A., & Nijs, C. H. (1993). Lack of selective attendance of participants at skin cancer/melanoma screening clinics. Journal of the American Academy of Dermatology, 29, 423–427.

    PubMed  CAS  Article  Google Scholar 

  • Reynolds, D. (2007). Literature review of theory-based empirical studies examining adolescent tanning practices. Dermatology Nursing, 19, 440–443.

    PubMed  Google Scholar 

  • Reynolds, K. D., Blaum, J. M., Jester, P. M., Weiss, H., Soong, S. J., & Diclemente, R. J. (1996). Predictors of sun exposure in adolescents in a southeastern U.S. population. Journal of Adolescent Health, 19, 409–415.

    PubMed  CAS  Article  Google Scholar 

  • Robinson, J. K. (1990). Behavior modification obtained by sun protection education coupled with removal of a skin cancer. Archives of Dermatology, 126, 477–481.

    PubMed  CAS  Article  Google Scholar 

  • Robinson, J., Rademaker, A., Sylvester, J., & Cook, B. (1997a). Knowledge, attitudes, and behaviors of midwest adolescents. Preventive Medicine, 26, 364–372.

    PubMed  CAS  Article  Google Scholar 

  • Robinson, J. K., Rademaker, A. W., Sylvester, J. A., & Cook, B. (1997b). Summer sun exposure: Knowledge, attitudes, and behaviors of Midwest adolescents. Preventive Medicine, 26, 364–372.

    PubMed  CAS  Article  Google Scholar 

  • Robinson, J., Rigel, D., & Amonette, R. (1998). What promotes skin self-examination? Journal of the American Academy of Dermatology, 39, 752–757.

    Article  Google Scholar 

  • Robinson, J. K., Rigel, D. S., & Amonette, R. A. (2000). Summertime sun protection used by adults for their children. Journal of the American Academy of Dermatology, 42, 746–753.

    PubMed  CAS  Article  Google Scholar 

  • Robinson, J., Fisher, S., & Turrisi, R. (2002). Predictors of skin self-examination performance. Cancer, 95, 135–146.

    PubMed  Article  Google Scholar 

  • Rodriguez, G. L., Ma, F., Federman, D. G., Rouhani, P., Chimento, S., Multach, M., et al. (2007). Predictors of skin cancer screening practice and attitudes in primary care. Journal of the American Academy of Dermatology, 57, 775–781.

    PubMed  Article  Google Scholar 

  • Rosenman, K. D., Gardiner, J., Swanson, G. M., Mullan, P., & Zhu, Z. (1995). Use of skin-cancer prevention strategies among farmers and their spouses. American Journal of Preventive Medicine, 11, 342–347.

    PubMed  CAS  Google Scholar 

  • Rosenstock, I. (1974). The Health Belief Model and preventive health behaviour. In M. Becker (Ed.), The Health Belief Model and personal health behaviour (pp. 27–59). Thorofare: Charles B Slack.

    Google Scholar 

  • Santmyire, B. R., Feldman, S. R., & Fleischer, A. B., Jr. (2001). Lifestyle high-risk behaviors and demographics may predict the level of participation in sun-protection behaviors and skin cancer primary prevention in the United States: Results of the 1998 National Health Interview Survey. Cancer, 92, 1315–1324.

    PubMed  CAS  Article  Google Scholar 

  • Saraiya, M., Hall, H. I., Thompson, T., Hartman, A., Glanz, K., Rimer, B., et al. (2004). Skin cancer screening among U.S. adults from, 1992, 1998, and 2000 National Health Interview Surveys. Preventive Medicine, 39, 308–314.

    PubMed  Article  Google Scholar 

  • Savona, M. R., Jacobsen, M. D., James, R., & Owen, M. D. (2005). Ultraviolet radiation and the risks of cutaneous malignant melanoma and non-melanoma skin cancer: Perceptions and behaviours of Danish and American adolescents. European Journal of Cancer Prevention, 14, 57–62.

    PubMed  CAS  Article  Google Scholar 

  • Scerri, L., Aquilina, S., Amato, G. A., & Dalmas, M. (2002). Sun awareness and sun protection practices in Malta. Journal of European Academy Dermatology and Venereology, 16, 47–52.

    CAS  Article  Google Scholar 

  • Schofield, P. E., Freeman, J. L., Dixon, H. G., Borland, R., & Hill, D. J. (2001). Trends in sun protection behaviour among Australian young adults. Australian and New Zealand Journal of Public Health, 25, 62–65.

    PubMed  CAS  Article  Google Scholar 

  • Schwartz, J. L., Wang, T. S., Hamilton, T. A., Lowe, L., Sondak, V. K., & Johnson, T. M. (2002). Thin primary cutaneous melanomas: Associated detection patterns, lesion characteristics, and patient characteristics. Cancer, 95, 1562–1568.

    PubMed  Article  Google Scholar 

  • Scully, M., Wakefield, M., & Dixon, H. (2008). Trends in news coverage about skin cancer prevention, 1993–2006: Increasingly mixed messages for the public. Australian and New Zealand Journal of Public Health, 32, 461–466.

    PubMed  Article  Google Scholar 

  • Sheer, B. (1999). Issues in summer safety: A call for sun protection. Pediatric Nursing, 25, 319–324.

    PubMed  CAS  Google Scholar 

  • Shoveller, J. A., Lovato, C. Y., Peters, L., & Rivers, J. K. (1998). Canadian National Survey on sun exposure & protective behaviours: Adults at leisure. Cancer Prevention & Control, 2, 111–116.

    CAS  Google Scholar 

  • Sjoberg, L., Holm, L. -E., Ullen, H., & Brandberg, Y. (2004). Tanning and risk perception in adolescents. Health, Risk &Society, 6, 81–94.

    Article  Google Scholar 

  • Smith, R., Cokkinides, V., & Eyre, H. (2005). American Cancer Society guidelines for the early detection of cancer. CA: A Cancer Journal for Clinicians, 55, 31–44.

    Article  Google Scholar 

  • Stanton, W., Janda, M., Baade, P., & Anderson, P. (2004). Primary prevention of skin cancer: A review of sun protection in Australia and internationally. Health Promotion International, 19, 369–378.

    PubMed  Article  Google Scholar 

  • Stepanski, B. M., & Mayer, J. A. (1998). Solar protection behaviors among outdoor workers. Journal of Occupational and Environmental Medicine, 40, 43–48.

    PubMed  CAS  Article  Google Scholar 

  • Stott, M. A. (1999). Tanning and sunburn: Knowledge, attitudes and behaviour of people in Great Britain. Journal of Public Health Medicine, 21, 377–384.

    PubMed  CAS  Article  Google Scholar 

  • Tamir, D., Tamir, J., Dayan, I., Josef, H., Orenstein, A., & Shafir, R. (2002). Positive changes in sun-related behavior in Israel (1994–1998). Preventive Medicine, 35, 369–375.

    PubMed  Article  Google Scholar 

  • Temoshok, L., Heller, B. W., Sagebiel, R. W., Blois, M. S., Sweet, D. M., DiClemente, R. J., et al. (1985). The relationship of psychosocial factors to prognostic indicators in cutaneous malignant melanoma. Journal of Psychosomatic Research, 29, 139–153.

    PubMed  CAS  Article  Google Scholar 

  • The Cancer Council Australia. (2004). Position statement: Screening and early detection of skin cancer. Australia: The Cancer Council Australia.

    Google Scholar 

  • The Cancer Council Australia. (2007). National Cancer Prevention Policy 2007–09. New South Wales: The Cancer Council Australia.

    Google Scholar 

  • Tucker, M., & Goldstein, A. (2003). Melanoma etiology: Where are we? Oncogene, 22, 3042–3052.

    PubMed  CAS  Article  Google Scholar 

  • Turrisi, R., Hillhouse, J., Gebert, C., & Grimes, J. (1999). Examination of cognitive variables relevant to sunscreen use. Journal of Behavioral Medicine, 22, 493–509.

    PubMed  CAS  Article  Google Scholar 

  • Weinstock, M., Martin, R., Risica, P., Berwick, M., Lasater, T., Rakowski, W., et al. (1999). Thorough skin examination for the early detection of melanoma. American Journal of Preventive Medicine, 17, 169–175.

    PubMed  CAS  Article  Google Scholar 

  • Weinstock, M. A., Rossi, J. S., Redding, C. A., Maddock, J. E., & Cottrill, S. D. (2000). Sun protection behaviors and stages of change for the primary prevention of skin cancers among beachgoers in southeastern New England. Annals of Behavioral Medicine, 22, 286–293.

    PubMed  CAS  Article  Google Scholar 

  • Weinstock, M. A., Risica, P. M., Martin, R. A., Rakowski, W., Smith, K. J., Berwick, M., et al. (2004). Reliability of assessment and circumstances of performance of thorough skin self-examination for the early detection of melanoma in the Check-It-Out Project. Preventive Medicine, 38, 761–765.

    PubMed  Article  Google Scholar 

  • Whiteman, D., Watt, P., Purdie, D., Hughes, M., Hayward, N., & Green, A. (2003). Melanocytic nevi, solar keratoses, and divergent pathways to cutaneous melanoma. Journal of the National Cancer Institute, 95, 806–812.

    PubMed  Article  Google Scholar 

  • Wichstrom, L. (1994). Predictors of Norwegian adolescents’ sunbathing and use of sunscreen. Health Psychology, 13, 412–420.

    PubMed  CAS  Article  Google Scholar 

  • Youl, P. H., Janda, M., & Kimlin, M. (2009). Vitamin D and sun protection: The impact of mixed public health messages in Australia. International Journal of Cancer, 124, 1963–1970.

    CAS  Article  Google Scholar 

Download references

Financial support

Nadine Kasparian is supported by a Post-Doctoral Clinical Research Fellowship from the National Health and Medical Research Council of Australia (NH&MRC ID 510399). Bettina Meiser is supported by a Career Development Award from the National Health and Medical Research Council of Australia (NH&MRC ID 350989). This project was also supported by The Cancer Council NSW Strategic Research Partnership Grant (ID SRP06-X5), and a Cancer Institute NSW Program Grant for Excellence in Translational Research.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nadine A. Kasparian.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Kasparian, N.A., McLoone, J.K. & Meiser, B. Skin cancer-related prevention and screening behaviors: a review of the literature. J Behav Med 32, 406–428 (2009). https://doi.org/10.1007/s10865-009-9219-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-009-9219-2

Keywords

  • Skin cancer
  • Melanoma
  • Skin self-examination
  • Clinical skin examination
  • Sun protection behaviors
  • Health behavior prediction