title: Ultraviolet radiation and the risks of cutaneous malignant melanoma and non-melanoma skin cancer: perceptions and behaviours of Danish and American adolescents.
abstract: The highest prevalence rates of skin malignancy in the northern hemisphere occur in Scandinavia and the United States (USA). Most Danes and Americans receive 50% of their lifetime ultraviolet (UV) radiation before the age of 21, making it important to address sun exposure risks with adolescents. The project was undertaken to determine differences between Danish and American adolescents in knowledge of sun exposure and skin malignancy, activities accounting for sun exposure, and means used for sun protection. Questionnaires regarding skin cancer and sun exposure were distributed to 674 secondary school age students in Hilleroed, Denmark, and to 483 similarly aged students in Winston-Salem, North Carolina, USA. Differences in responses between and within groups were compared. American adolescents had more knowledge of the characteristics and malignant potential of melanoma than did Danish adolescents. Danish youth and females from both countries were significantly more likely to engage in sunbathing and tanning bed use. Black Danish students reported significantly more sunburn and were more likely to sunbathe or use a tanning bed than were black American students. Danish students were more likely than Americans to use sunscreen, however, Americans were more likely to apply sun protective factor (SPF) 15 or greater. In conclusion, given that sunbathing and tanning bed use are associated with the development of precancerous lesions and skin malignancy, Danish teens are at increased risk. The rates of skin malignancy are relatively high in Scandinavia and efforts to improve understanding of exposure and cancer risks should be undertaken in adolescents.
authors.affiliation: Department of Internal Medicine, David Grant Medical Center, 101 Bodin Circle, Travis Air Force Base, Fairfield, California, 94535, USA. msavona@charter.net
authors.forename: M R
authors.initials: MR
authors.lastname: Savona
authors.forename: M D
authors.initials: MD
authors.lastname: Jacobsen
authors.forename: R
authors.initials: R
authors.lastname: James
authors.forename: M D
authors.initials: MD
authors.lastname: Owen
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D003718:Denmark; D004781:Environmental Exposure; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D008297:Male; D008545:Melanoma / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology; D010465:Perception; D012307:Risk Factors; D012737:Sex Factors; D012878:Skin Neoplasms / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology; D014466:Ultraviolet Rays / Q000009:adverse effects*; D014481:United States