Skin cancer awareness and sunscreen use among outpatients of a South African hospital: need for vigorous public education

Abstract

Background: Melanoma incidence among white South Africans is increasing. Among black individuals, melanoma is associated with advanced stage at presentation and significant mortality.

Objectives: A study was undertaken to assess the perception of skin cancer risk, knowledge of skin cancer, and understanding of the importance and use of sunscreens among South Africans.

Methods: A cross-sectional survey was conducted in general outpatients over four months at a large central hospital in Durban, South Africa.

Results: Only half the white respondents reported regular use of a sunscreen. Among black and Indian respondents, the number was substantially lower. Less than 20% of white respondents had ever checked their skin for suspicious moles. Most black patients were not aware that they are at risk of skin cancer, and only 10% were aware of the risk of developing skin cancers on acral sites and nails.

Conclusions: There is a worrying lack of knowledge about skin cancer and sun protection behaviours among all South Africans. Given the increase in melanoma incidence and racial disparities in survival rates, it is imperative to target each population with effective, culturally sensitive educational programmes.

Keywords:

• education
• melanoma
• prevention
• screening
• skin cancer
• South Africa
• sunscreen

Acknowledgements

The authors would like to thank their colleagues in the Department of Dermatology, Ms Phakama Jika, Ms Lungie Shabalala and Mrs T. Yeni of Durban for data collection and administrative support.

Ethical approval

Received from the University of KwaZulu-Natal Biomedical Research Ethics Committee (BE 180/11). We studied the three largest ethnic groups in Durban: indigenous African, Indian (a large population founded by South-Asian immigrants in the nineteenth century), both of whom are of Fitzpatrick skin types 4–6, and white (Fitzpatrick types 1–4). A power analysis suggested that 300 subjects from each ethnic group were required to demonstrate significant differences in responses. All subjects provided written informed consent.