title: Assessment of knowledge of melanoma risk factors, prevention, and detection principles in Texas teenagers.
abstract: BACKGROUND
  The incidence of melanoma has increased in the past 10 years more rapidly than any other cancer. Exposure to intense solar radiation in youth significantly increases the lifetime risk of developing melanoma. We postulate that teenagers have little awareness of melanoma prevention or detection principles. The purpose of this study was to assess the knowledge of teenagers about melanoma and to identify which age groups are most receptive to altering their sun exposure behaviors.
  
  
  METHODS
  Two hundred and ten examinations testing general knowledge of sun exposure and melanoma were completed and returned by junior high and high school students ages 12 to 18 in Dallas and Houston, Texas. All students completing and returning the examination were provided with the correct answers to the test and a detailed explanation of each of the test items as part of an educational exercise. A second questionnaire was then administered to determine the effect of the educational exercise on future sun exposure practices. Students were divided into two age groups (12 to 15 and >or=16 years old) for comparison of scores on the knowledge examination and responses to behavioral items. Comparison of response rates between age groups was performed using chi(2) analysis.
  
  
  RESULTS
  The return rate was 100%, with 109 students age 12-15 years, and 101 students >or=16 years. Seventy-six percent of all respondents sunbathed outdoors, and 18% had used a tanning bed in the past 6 months. Thirty-three percent of students admitted to at least three blistering sunburns in the past. The average score on the knowledge assessment examination was 65% correct for students >or=16 years old and 54% correct for those 12-15 years old. Students 12 to 15 years old were significantly more likely to indicate they planned to change future behaviors regarding performance of skin self-examinations and limiting sun exposure as compared to the older students.
  
  
  CONCLUSIONS
  A significant number of teenagers have already enhanced their risk for future melanoma by suffering severe sunburns. Students younger than 16 years of age were significantly more likely to indicate they planned to change future behaviors after receiving information about melanoma. The data from this pilot study support education aimed at younger age groups to most effectively achieve risk reduction and prevent future melanomas.
authors.affiliation: Michael E. Debakey Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA. alucci@bcm.tmc.edu
authors.forename: A
authors.initials: A
authors.lastname: Lucci
authors.forename: H W
authors.initials: HW
authors.lastname: Citro
authors.forename: L
authors.initials: L
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D020380:Needs Assessment; D010353:Patient Education as Topic; D012307:Risk Factors; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D012880:Skin Pigmentation / Q000235:genetics; D013472:Sunlight / Q000009:adverse effects; D013781:Texas