Educational level-dependent melanoma awareness in a high-risk population in Switzerland

Alina Miriam Mueller; Elisabeth Victoria Goessinger; Sara Elisa Cerminara; Lisa Kostner; Margarida Amaral; Stephanie Marie Huber; Lea Pauline Passweg; Laura Garcia Moreno; Daniel Bodenmann; Michael Kunz; Mitchell Paul Levesque; Julia-Tatjana Maul; Phil Fang Cheng; Alexander Andreas Navarini; Lara Valeska Maul

doi:10.3389/fonc.2023.1174542

Educational level-dependent melanoma awareness in a high-risk population in Switzerland

Front Oncol. 2023 May 3:13:1174542. doi: 10.3389/fonc.2023.1174542. eCollection 2023.

Authors

Alina Miriam Mueller^{1

2}, Elisabeth Victoria Goessinger^{1

2}, Sara Elisa Cerminara^{1

2}, Lisa Kostner^{1

2}, Margarida Amaral¹, Stephanie Marie Huber¹, Lea Pauline Passweg², Laura Garcia Moreno², Daniel Bodenmann², Michael Kunz¹, Mitchell Paul Levesque^{3

4}, Julia-Tatjana Maul^{3

4}, Phil Fang Cheng³, Alexander Andreas Navarini^{1

2}, Lara Valeska Maul^{1

2}

Affiliations

¹ Department of Dermatology, University Hospital of Basel, Basel, Switzerland.
² Faculty of Medicine, University of Basel, Basel, Switzerland.
³ Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.
⁴ Faculty of Medicine, University of Zurich, Zurich, Switzerland.

Abstract

Introduction: The worldwide incidence of melanoma has been increasing rapidly in recent decades with Switzerland having one of the highest rates in Europe. Ultraviolet (UV) radiation is one of the main risk factors for skin cancer. Our objective was to investigate UV protective behavior and melanoma awareness in a high-risk cohort for melanoma.

Methods: In this prospective monocentric study, we assessed general melanoma awareness and UV protection habits in at-risk patients (≥100 nevi, ≥5 dysplastic nevi, known CDKN2A mutation, and/or positive family history) and melanoma patients using questionnaires.

Results: Between 01/2021 and 03/ 2022, a total of 269 patients (53.5% at-risk patients, 46.5% melanoma patients) were included. We observed a significant trend toward using a higher sun protection factor (SPF) in melanoma patients compared with at-risk patients (SPF 50+: 48% [n=60] vs. 26% [n=37]; p=0.0016). Those with a college or university degree used a high SPF significantly more often than patients with lower education levels (p=0.0007). However, higher educational levels correlated with increased annual sun exposure (p=0.041). Neither a positive family history for melanoma, nor gender or Fitzpatrick skin type influenced sun protection behavior. An age of ≥ 50 years presented as a significant risk factor for melanoma development with an odd's ratio of 2.32. Study participation resulted in improved sun protection behavior with 51% reporting more frequent sunscreen use after study inclusion.

Discussion: UV protection remains a critical factor in melanoma prevention. We suggest that melanoma awareness should continue to be raised through public skin cancer prevention campaigns with a particular focus on individuals with low levels of education.

Keywords: awareness; education; melanoma; prevention; sunscreen.

Grants and funding

This research project was fully funded by the Department of Dermatology, as well as to a minor part by the Research Foundation for Young Researchers Grant of the University of Basel, Switzerland and by the Voluntary Academic Society Grant, Basel, Switzerland.