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Family Physicians' Awareness of Skin Cancer and Sun Protection Practices

Yıl 2021, Cilt: 15 Sayı: 2, 223 - 229, 20.06.2021
https://doi.org/10.21763/tjfmpc.829114

Öz

Objective: The objective of this study was to determine the knowledge level of family physicians about skin cancer and their attitudes and behaviors about sun protection. Methods: The sample of this study was composed of 295 family physicians who worked in Samsun province and participated in in-service trainings organized by the Provincial Health Directorate in March 2019. A questionnaire form consisting of questions on sociodemographic characteristics, attitudes and behaviors about sun protection was applied to the participants. Result: A total of 295 family physicians, 64.7% male and 35.3% female, participated in the study. Most of the physicians (87.8%) expressed that they tried to protect from sunlight. Women (68.3%) used sunscreen lotions/creams more frequently than men (41.4%). Those who had 2 and more severe sunburns throughout their lifetime (51.5%) stated that they described themselves at higher risk than those who did not (36.2%) which was statistically significant (p<0.05). The reasons of the physicians for application to a dermatologist were: 47(15.9%) had asymmetrically shaped, irregularly structured moles larger than 5 mm, 37(12.5%) had suspected presence of moles, 11(3.7%) wanted whole body examination for moles, 20(6.8%) requested advice on daily skin care and prevention of skin aging. Conclusion: Awareness studies should be carried out on the harmful effects of the sun and early diagnosis of skin cancer especially for family physicians, healthcare professionals and other parts of the society. In addition, considering that visual evaluation has a role in the diagnosis of skin cancer, it will be useful for family physicians to inform their patients about the detrimental effects of the sun and self-skin examination.

Teşekkür

We thank Ferda ÇELİK, MD for their contribution to the study.

Kaynakça

  • 1. IARC monographs on the evaluation of carcinogenic risks to humans Volume 100D [electronic resource]. Lyon (France): 2012: 35-101. [cited 2019 Feb 14]. Available from: http://monographs.iarc.fr/ENG/Monographs/vol100D/mono100D.pdf.
  • 2. Özuğuz P, Kaçar Doğruk S, Akyükrek Tuncez F, Üzel H. Evaluation of First Class and End Class of Medical Students' Knowledge and Behaviors About the Sun and the Skin. Turk J Dermatol. 2014;8(1):19-22.
  • 3. Mohiuddin AK. Sunscreen and suntan preparations. ARC Journal of Pharmaceutical Sciences (AJPS). 2019; 5(2):8-44.
  • 4. Polefka TG, Meyer TA, Agin PP, Bianchin RJ. Effects of solar radiation on the skin. J Cosmet Dermatol. 2012; 11: 134–43.
  • 5. Armstrong BK, Cust AE. Sun Exposure and Skin Cancer and the Puzzle of Cutaneous Melanoma. Cancer Epidemiol. 2017; 48: 147–56.
  • 6. Perera E, Gnaneswaran N, Staines C, Win AK, Sinclair R. Incidence and prevelance of non-melanoma skin cancer in Australia: A systematic review. Australas J Dermatol. 2015;56(4):258- 67.
  • 7. Uslu M, Karaman G, Şavk E, Şendur N. İnvestigation of knowledge about sun effects, skin cancer and sun protection behaviour among doctors in Adnan Menderes Hospital. Adnan Menderes University Faculty of Medicine Journal. 2006; 7 (1): 5-10.
  • 8. Yurtseven E, Ulus T, Vehid S, Köksal S, Bosat M, Akkoyun K. Assessment of knowledge, behaviour and sun protection practices among health services vocational school students. Int J Environ Res Public Health. 2012;9(7):2378–85.
  • 9. Tas F. Age-specific incidence ratios in malignant melanoma in Turkey: melanoma in older people is increasing. Acta Derm Venereol. 2011;91(3):353-4.
  • 10. Usher-Smith JA, Emery J, Kassianos AP, Walter FM. Risk prediction models for melanoma: a systematic review. Cancer Epidemiol Biomarkers Prev. 2014;23 (8):1450-63. 11. International Agency for Research on Cancer, Cancer Today. [cited 2019 Jul 17]. Available from: https://gco.iarc.fr/today/home
  • 12. Abali H, Celik I, Karaca B, Turna H, Kaytan Sağlam E, Akman T, Öztop I, et al. Cutaneous melanoma in Turkey: Analysis of 1157 patients in the melanoma Turkish study. J BUON. 2015; 20(4):1137-41.
  • 13. Turkey melanoma roadmap. [cited 2019 Feb 14]. Available from: https://hsgm.saglik.gov.tr/depo/birimler/kanserdb/yayinlar/raporlar/Melanom_Yol_Haritasi_II.pdf
  • 14. Balcı E, Durmuş H, Arslantaş E, Gün İ. Knowledge, Attitudes and Behaviors of Adults Applying to Primary Health Care Organizations on the Harmful Effects of the Sun and the Ways of Protection. Turk J Dermatol. 2018;12: 96-99.
  • 15. Gritz ER, Tripp MK, de Moor CA. Skin cancer prevention counseling and clinical practices of pediatricians. Pediatr Dermatol. 2003;20:16-24.
  • 16. Altunel CT, Kartal SP. Skin Changes (Photoaging) and Dermatoses (Photodermatoses) Due to Sunlight. Akgül A, editor. Gerontological/65 + Skin and Its Problems.1st Edition. Ankara: Turkey Clinics. 2019; p.9-13.
  • 17. Council ML. Common skin cancers in older adults: approach to diagnosis and management. Clin Geriatr Med. 2013;29(2):,361- 72.
  • 18. Narayanan DL, Saladi RN, Fox JL. Ultraviolet radiation and skin cancer. Int J Dermatol. 2010; 49(9): 978-86.
  • 19. Oğrum A. ve Oktay G. Evaluation of sun-protective behaviors and preventive medicine practices of family physicians for skin cancer. Turkish Journal of Family Practice 2019; 23(3):110-7.
  • 20. Terzi S, Başak PY, Erturan İ. Evaluation of knowledge, attitude and behavior about harmful effects of the sun and sun protection among patients attending an out patient clinic. Turkderm-Turk Arch Dermatol Venereology. 2017;51:2-7.
  • 21. De Blacam C, Dermott CM, Sugrue C, Kilmartin D, Kelly J. Patient awareness and sun protection behaviour following excision of basal cell carcinoma. Surgeon. 2017; 15(1): 12–7.
  • 22. Ağadayı E, Demir Alsancak A, Üstünol D, Şencan İ, Küçükceran H, Kahveci R, et al. Assessment of Malignant Melanoma Risk Factors and Their Attitudes Towards Protection from the Sun in Patients Applying to Family Physician Polyclinics. Konuralp Medical Journal. 2017;9(3):1-6.
  • 23. Çayırlı M, Tunca M, Açıkgöz G. Sun protection and sunscreens. TAF Preventive Medicine Bulletin. 2013;12(2), 193-98.
  • 24. Green AC, Williams GM, Logan V, Strutton GM. Reduced melanoma after regular sunscreen use: randomized trial follow-up. Journal of Clinical Oncology. 2010;29(3):257-63.
  • 25. Williams JD, Maitra P, Atillasoy E, Wu MM, Farberg AS, Rigel DS. SPF 100+ sunscreen is more protective against sunburn than SPF 50+ in actualuse: results of a randomized, double-blind, split-face, natural sunlight exposure clinical trial. J Am Acad Dermatol. 2018;78 (5):902–10.
  • 26. Wu S, Cho E, Li WQ, Weinstock MA, Han J, Qureshi AA. History of severe sunburn and risk of skin cancer among women and men in 2 prospective cohort studies. Am J Epidemiol. 2016; 183: 824– 33.
  • 27. Flament F, Bazin R, Laquieze S, Rubert V, Simonpietri E, Piot B. Effect of the sun on visible clinical signs of aging in Caucasian skin. Clin Cosmet Investig Dermatol. 2013; 27(6):221-32.
  • 28. World Health Organization. Sun protection; a primary teaching resource. [cited 2019 May 14]. Available from: https://www.who.int/uv/publications/en/primaryteach.pdf
  • 29. Gordon JR, Brieva JC. Images in clinical medicine. Unilateral dermatoheliosis. N Engl J Med. 2012; 366(16): 25.
  • 30. Tripp MK, Watson M, Balk SJ, Swetter SM, Gershenwald JE. State of thescience on prevention and screening to reduce melanoma incidence and mortality: The time is now. CA Cancer J Clin. 2016; 66(6):460-80.
  • 31. Glazer AM, Rigel DS, Winkelmann RR, Farberg AS. Clinical diagnosis of skin cancer: Enhancing Inspection and Early Recognition. Dermatol Clin. 2017; 35(4):409-16.
  • 32. Geller AC, Johnson TM, Miller DR, Brooks KR, Layton CJ, Swetter SM. Factors associated with physician discovery of early melanoma in middle-aged and older men. Arch Dermatol. 2009;145(4):409-14.
  • 33. Koelink CJ, Kollen BJ, Groenhof F, Van der Meer K, van der Heide WK. Skin lesions suspected of malignancy: an increasing burden on general practice. BMC Fam Pract. 2014; 12(15):29.
  • 34. Melanoma. [cited 2019 May 14]. Available from: https://www.nccn.org/patients/guidelines/content/PDF/melanoma-patient.pdf
  • 35. How to Do a Skin Self-Exam. [cited 2019 May 14 ]. Available from: https://www.cancer.org/healthy/be-safe-in-sun/skin-exams.html l

Aile Hekimlerinin Cilt Kanseri Farkındalıkları ve Güneşten Korunma Davranışları

Yıl 2021, Cilt: 15 Sayı: 2, 223 - 229, 20.06.2021
https://doi.org/10.21763/tjfmpc.829114

Öz

Amaç: Bu çalışmada aile hekimlerinin cilt kanserleri hakkındaki bilgi düzeylerinin ve güneşten korunma ile ilgili tutum ve davranışlarının belirlenmesi amaçlanmıştır. Metod: Bu çalışma Samsun ilinde görev yapan ve İl Sağlık Müdürlüğünün 2019 yılı Mart ayı içerisinde düzenlediği hizmet içi eğitimlere katılan 295 aile hekimi ile yapıldı. Katılımcılara sosyodemografik özellikler ile güneşten korunma konusundaki tutum ve davranışlarına yönelik sorulardan oluşan anket formu uygulandı. Bulgular: Çalışmaya %64,7’si erkek, %35,3’ü kadın toplam 295 aile hekimi katıldı. Hekimlerin %87,8’i güneşten korunmaya çalıştığını belirtti. Kadınlar (%68,3) erkeklere (%41,4) göre daha fazla koruyucu losyon/krem kullandığını, hayatı boyunca 2 ve daha fazla şiddetli güneş yanığı geçirenler (%51,5), geçirmeyenlere göre (%36,2) istatistiksel anlamlı düzeyde kendilerini daha yüksek sıklıkta riskli bulduklarını ifade etti. Hekimlerin 47’si (%15,9) vücudunda 5 mm’den büyük, asimetrik şekilli, düzensiz yapılı ben olduğunu; 37’si (%12,5) şüpheli ben muayenesi, 11’i (%3,7) benlerinin incelenmesi için tüm vücut muayenesi amaçlı, 11’i (%3,7) güneşten korunmayla ilgili bilgi edinmek amacıyla, 20’si (%6,8) ise günlük deri bakımı ve deri yaşlanmasının engellenmesi hakkında öneri almak amacıyla dermatoloji uzmanına başvurduğunu söyledi. Sonuç: Güneşin zararlı etkileri ve cilt kanserinin erken tanısıyla ilgili aile hekimleri başta olmak üzere sağlık çalışanlarında ve toplumun diğer kesimlerinde farkındalık çalışmaları yapılmalıdır. Ayrıca cilt kanserinin tanısında görsel değerlendirmenin de yeri olduğu düşünüldüğünde aile hekimlerinin hastalarını güneşin zararlı etkileri ve kendi kendine deri muayenesi hakkında bilgilendirmesinin erken tanıda faydalı olacağı düşünülmektedir.

Kaynakça

  • 1. IARC monographs on the evaluation of carcinogenic risks to humans Volume 100D [electronic resource]. Lyon (France): 2012: 35-101. [cited 2019 Feb 14]. Available from: http://monographs.iarc.fr/ENG/Monographs/vol100D/mono100D.pdf.
  • 2. Özuğuz P, Kaçar Doğruk S, Akyükrek Tuncez F, Üzel H. Evaluation of First Class and End Class of Medical Students' Knowledge and Behaviors About the Sun and the Skin. Turk J Dermatol. 2014;8(1):19-22.
  • 3. Mohiuddin AK. Sunscreen and suntan preparations. ARC Journal of Pharmaceutical Sciences (AJPS). 2019; 5(2):8-44.
  • 4. Polefka TG, Meyer TA, Agin PP, Bianchin RJ. Effects of solar radiation on the skin. J Cosmet Dermatol. 2012; 11: 134–43.
  • 5. Armstrong BK, Cust AE. Sun Exposure and Skin Cancer and the Puzzle of Cutaneous Melanoma. Cancer Epidemiol. 2017; 48: 147–56.
  • 6. Perera E, Gnaneswaran N, Staines C, Win AK, Sinclair R. Incidence and prevelance of non-melanoma skin cancer in Australia: A systematic review. Australas J Dermatol. 2015;56(4):258- 67.
  • 7. Uslu M, Karaman G, Şavk E, Şendur N. İnvestigation of knowledge about sun effects, skin cancer and sun protection behaviour among doctors in Adnan Menderes Hospital. Adnan Menderes University Faculty of Medicine Journal. 2006; 7 (1): 5-10.
  • 8. Yurtseven E, Ulus T, Vehid S, Köksal S, Bosat M, Akkoyun K. Assessment of knowledge, behaviour and sun protection practices among health services vocational school students. Int J Environ Res Public Health. 2012;9(7):2378–85.
  • 9. Tas F. Age-specific incidence ratios in malignant melanoma in Turkey: melanoma in older people is increasing. Acta Derm Venereol. 2011;91(3):353-4.
  • 10. Usher-Smith JA, Emery J, Kassianos AP, Walter FM. Risk prediction models for melanoma: a systematic review. Cancer Epidemiol Biomarkers Prev. 2014;23 (8):1450-63. 11. International Agency for Research on Cancer, Cancer Today. [cited 2019 Jul 17]. Available from: https://gco.iarc.fr/today/home
  • 12. Abali H, Celik I, Karaca B, Turna H, Kaytan Sağlam E, Akman T, Öztop I, et al. Cutaneous melanoma in Turkey: Analysis of 1157 patients in the melanoma Turkish study. J BUON. 2015; 20(4):1137-41.
  • 13. Turkey melanoma roadmap. [cited 2019 Feb 14]. Available from: https://hsgm.saglik.gov.tr/depo/birimler/kanserdb/yayinlar/raporlar/Melanom_Yol_Haritasi_II.pdf
  • 14. Balcı E, Durmuş H, Arslantaş E, Gün İ. Knowledge, Attitudes and Behaviors of Adults Applying to Primary Health Care Organizations on the Harmful Effects of the Sun and the Ways of Protection. Turk J Dermatol. 2018;12: 96-99.
  • 15. Gritz ER, Tripp MK, de Moor CA. Skin cancer prevention counseling and clinical practices of pediatricians. Pediatr Dermatol. 2003;20:16-24.
  • 16. Altunel CT, Kartal SP. Skin Changes (Photoaging) and Dermatoses (Photodermatoses) Due to Sunlight. Akgül A, editor. Gerontological/65 + Skin and Its Problems.1st Edition. Ankara: Turkey Clinics. 2019; p.9-13.
  • 17. Council ML. Common skin cancers in older adults: approach to diagnosis and management. Clin Geriatr Med. 2013;29(2):,361- 72.
  • 18. Narayanan DL, Saladi RN, Fox JL. Ultraviolet radiation and skin cancer. Int J Dermatol. 2010; 49(9): 978-86.
  • 19. Oğrum A. ve Oktay G. Evaluation of sun-protective behaviors and preventive medicine practices of family physicians for skin cancer. Turkish Journal of Family Practice 2019; 23(3):110-7.
  • 20. Terzi S, Başak PY, Erturan İ. Evaluation of knowledge, attitude and behavior about harmful effects of the sun and sun protection among patients attending an out patient clinic. Turkderm-Turk Arch Dermatol Venereology. 2017;51:2-7.
  • 21. De Blacam C, Dermott CM, Sugrue C, Kilmartin D, Kelly J. Patient awareness and sun protection behaviour following excision of basal cell carcinoma. Surgeon. 2017; 15(1): 12–7.
  • 22. Ağadayı E, Demir Alsancak A, Üstünol D, Şencan İ, Küçükceran H, Kahveci R, et al. Assessment of Malignant Melanoma Risk Factors and Their Attitudes Towards Protection from the Sun in Patients Applying to Family Physician Polyclinics. Konuralp Medical Journal. 2017;9(3):1-6.
  • 23. Çayırlı M, Tunca M, Açıkgöz G. Sun protection and sunscreens. TAF Preventive Medicine Bulletin. 2013;12(2), 193-98.
  • 24. Green AC, Williams GM, Logan V, Strutton GM. Reduced melanoma after regular sunscreen use: randomized trial follow-up. Journal of Clinical Oncology. 2010;29(3):257-63.
  • 25. Williams JD, Maitra P, Atillasoy E, Wu MM, Farberg AS, Rigel DS. SPF 100+ sunscreen is more protective against sunburn than SPF 50+ in actualuse: results of a randomized, double-blind, split-face, natural sunlight exposure clinical trial. J Am Acad Dermatol. 2018;78 (5):902–10.
  • 26. Wu S, Cho E, Li WQ, Weinstock MA, Han J, Qureshi AA. History of severe sunburn and risk of skin cancer among women and men in 2 prospective cohort studies. Am J Epidemiol. 2016; 183: 824– 33.
  • 27. Flament F, Bazin R, Laquieze S, Rubert V, Simonpietri E, Piot B. Effect of the sun on visible clinical signs of aging in Caucasian skin. Clin Cosmet Investig Dermatol. 2013; 27(6):221-32.
  • 28. World Health Organization. Sun protection; a primary teaching resource. [cited 2019 May 14]. Available from: https://www.who.int/uv/publications/en/primaryteach.pdf
  • 29. Gordon JR, Brieva JC. Images in clinical medicine. Unilateral dermatoheliosis. N Engl J Med. 2012; 366(16): 25.
  • 30. Tripp MK, Watson M, Balk SJ, Swetter SM, Gershenwald JE. State of thescience on prevention and screening to reduce melanoma incidence and mortality: The time is now. CA Cancer J Clin. 2016; 66(6):460-80.
  • 31. Glazer AM, Rigel DS, Winkelmann RR, Farberg AS. Clinical diagnosis of skin cancer: Enhancing Inspection and Early Recognition. Dermatol Clin. 2017; 35(4):409-16.
  • 32. Geller AC, Johnson TM, Miller DR, Brooks KR, Layton CJ, Swetter SM. Factors associated with physician discovery of early melanoma in middle-aged and older men. Arch Dermatol. 2009;145(4):409-14.
  • 33. Koelink CJ, Kollen BJ, Groenhof F, Van der Meer K, van der Heide WK. Skin lesions suspected of malignancy: an increasing burden on general practice. BMC Fam Pract. 2014; 12(15):29.
  • 34. Melanoma. [cited 2019 May 14]. Available from: https://www.nccn.org/patients/guidelines/content/PDF/melanoma-patient.pdf
  • 35. How to Do a Skin Self-Exam. [cited 2019 May 14 ]. Available from: https://www.cancer.org/healthy/be-safe-in-sun/skin-exams.html l
Toplam 34 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm Orijinal Makaleler
Yazarlar

Hatice Nilden Arslan 0000-0002-3237-7123

Yasemin Kemal 0000-0002-1175-9085

Yayımlanma Tarihi 20 Haziran 2021
Gönderilme Tarihi 20 Kasım 2020
Yayımlandığı Sayı Yıl 2021 Cilt: 15 Sayı: 2

Kaynak Göster

Vancouver Arslan HN, Kemal Y. Family Physicians’ Awareness of Skin Cancer and Sun Protection Practices. TJFMPC. 2021;15(2):223-9.

Sağlığın ve birinci basamak bakımın anlaşılmasına ve geliştirilmesine katkıda bulunacak yeni bilgilere sahip yazarların İngilizce veya Türkçe makaleleri memnuniyetle karşılanmaktadır.

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