Relationship between risk factors, knowledge and preventive behaviour relevant to skin cancer in general practice patients in south Australia.

BACKGROUND There is an 'epidemic' increase in skin cancers worldwide in white-skinned populations. Australia has the highest incidence of skin cancer in the world despite intensive publicity in the last 30 years aimed at prevention. AIM This study set out to assess risk factors, knowledge and preventive behaviour relevant to skin cancer in general practice patients in South Australia, and to investigate the relationship between risk, knowledge and behaviour. METHOD A questionnaire on skin cancer was distributed to 980 patients aged 16 years and over attending general practitioners' surgeries in South Australia. A total of 810 questionnaires were analysed (83%). RESULTS There was a high overall level of knowledge and awareness of skin cancer. However, the majority of respondents were unaware of the risks of blue eyes (87%), fair hair (83%) or red hair (68%). A third of respondents were unaware that having lots of moles and freckles was a risk factor for skin cancer. A considerable minority were unaware of the risk of a fair complexion (26%), getting sunburnt (14%) or prolonged exposure to the sun (11%). Sunscreen cream was the most popular preventive behaviour (use reported by 74%), followed by clothing (54%), shade (16%) and timed sun exposure (13%). The most common number of methods of prevention used was two, but 16% were not able to mention anything that they did to prevent skin cancer. The correlations between presence of risk factors, knowledge and preventive behaviour were poor. CONCLUSION There was a high overall level of knowledge and awareness of skin cancer in South Australia but despite intense publicity, important areas of ignorance were still found to exist. The simpler methods of skin cancer prevention appeared to be neglected in favour of sunscreen cream. Those at high risk did not know more about skin cancer and reported doing little more to prevent it than those at low risk. There is a need to target those at high risk for education and screening. General practitioners, with adequate training, could have an important part to play in the primary and secondary prevention of mortality and morbidity from skin cancer.