Assessing a Sun Protection Program Aimed at Greek Elementary School Students for Malign Melanoma Prevention

Introduction: Numerous countries have launched campaigns regarding sun protection in the last decades. Aim: The aim of the present study was to assess an intervention program aimed at higher knowledge and healthier attitudes regarding sun protection. Materials and Methods: The sample consisted of 4,133 students aged 8-12 years from a single Greek province. Results: In most items, knowledge levels after the intervention were found to be higher than those before (2.8±0.9 vs 3.3±0.9), while knowledge about sun protection factors seems to have had the highest improvement (27.1% vs 56.6%). However, student attitudes did not appear to improve, with the exception of applying sunscreen with a higher SPF (29.7% vs 54.8%). Girls seemed to have healthier attitudes compared to boys, but gender played no role with regard to knowledge levels. Also, place of residence did not play any role regarding knowledge levels, although those living in semi-urban areas seemed to have more unhealthy attitudes. Logistic regression by correlating knowledge and attitudes established that higher knowledge levels are usually accompanied by healthier attitudes, albeit marginally. Conclusions: The intervention had a positive contribution to the student knowledge level regarding sun protection and also led to small improvements regarding some attitudes. Continuous similar interventions could lead to better results and the adoption of healthier attitudes.     

Sun Burn Incidence and Knowledge of Greek Elementary and High School Children about Sun Protection

Introduction: Overexposure to sun radiation and particularly its accumulation during childhood andadolescence is a significant risk factor for skin cancer development. The sun burn is particularly important. Aim:To estimate sun burn incidence in young pupils in a coastal area of Greece. Materials and Methods: Two surveyswere conducted in a school population in the same district in Greece, over different periods of time, in youngpeople 9 to 18 years old (n=2 977). Anonymous questionnaires were completed. Levels of significance were twotailedand statistical significance was set at p=0.05. SPSS 17.0 software was used for statistical analysis. Results:From the individual characteristics of the participants it was shown that the majority of them had dark hairand fair skin, whereas a significant percentage reported the existence of moles on face and their body (83.4% vs68.1%). The sun burn incidence was high in adolescents and the younger pupils (41.9% vs 55.6%). The youngeraged children who were living in an urban area had significantly higher rates of sun burn than those living insemi-urban areas (33.8% vs 24.8%, p=0.020). As far as the knowledge of pupils about the risks of sun radiationit was shown that the elementary school pupils had better knowledge than those at high school. Finally, thosewith better knowledge had the fewer sun burns (Mean 2.83 SD 0.87, p<0.001). Conclusions: The contributionof knowledge to the decrease of sun burn incidence is important as long as this is continuous. Therefore, theeducation should concern not only children but also teachers and parents in the context of continuous andsystematic programs of health education.     

Effect of Skin Cancer Training Provided to Maritime High School Students on Their Knowledge and Behaviour

Background: This study was conducted with the purpose of evaluating the effect of skin cancer training provided to maritime high school students on their knowledge and behaviour. Materials and Methods: The study had a quasi-experimental design with pre-test and post-test intervention and control groups. Two maritime high schools located in the city of Antalya were included within the scope of the study between March and June 2013, covering a total of 567 students. Results: While the knowledge mean scores of students regarding skin cancer and sun protection did not vary in the pre-test (6.2±1.9) and post-test (6.8±1.9) control group, the knowledge mean scores of students in the experimental group increased from 6.0±2.3 to 10.6±1.2 after the provided training. Some 25.4% of students in the experimental group had low knowledge level and 62.2% had medium knowledge level in the pre-test; whereas no students had low knowledge level and 94.3% had high knowledge level in the post-test. It was determined that tenth grade students, those who had previous knowledge on the subject, who considered themselves to be protecting from the sun better, had higher knowledge levels and their knowledge levels increased as the risk level increased. It was found that the provided training was effective and increased positively the knowledge, attitude and behaviour levels of students in the experimental group in terms of skin cancer and sun protection. Conclusions: Along with the provided training which started to form a lifestyle, appropriate attitudes and behaviours concerning skin cancer and sun protection could be brought to students who will work in outdoor spaces and are members of the maritime profession within the risk group.     

Sun Exposure and the Risk of Prostate Cancer in the Singapore Prostate Cancer Study: a Case-control Study

Background: Most of the epidemiology studies on the effects of sun exposure and prostate cancer wereconducted among the temperate countries of North America and Europe. Little is known about the influenceon Asian populations. The purpose of current study was to evaluate any association of sun exposure with riskof prostate cancer in Chinese, Malays and Indians who reside in the tropics. Methods: The Singapore ProstateCancer Study is a hospital-based case-control study of 240 prostate cancer incident cases and 268 controlsconducted in Singapore between April 2007 and May 2009. Detailed information on outdoor activities in thesun, skin colour, sun sensitivity and other possible risk factors were collected in personal interviews. Cases werefurther classified by Gleason scores and TNM staging. Odds ratios (OR) and 95% confidence intervals (CI) werecalculated using unconditional logistic regression analysis, adjusted for age, ethnicity, education, family historyof any cancers, BMI and skin colour. Results: We found that prostate cancer risk was increased in subjects withblack/dark-brown eyes (OR 5.88, 95%CI 3.17-10.9), darker skin colour e.g. tan/dark brown/black (OR 7.62,95%CI 3.41-17.0), frequent sunburn in lifetime (OR 4.30, 95%CI 1.7-11.2) and increased general sun exposure inadulthood per week (OR 2.03, 95%CI 1.09-3.81). The increased risk was consistent for high grade tumours andadvanced stage prostate cancers. Conclusion: The findings from this study suggest that excessive sun exposureis a risk factor for prostate cancer in Asians.     

Eating Habits,Knowledge about Cancer Prevention and the HPLP Scale in Turkish Adolescents

Background: Nutritional status and healthy lifestyle are important factors not only in cancer etiology butalso for prevention efforts. A good nutritional status contributes to a healthy life with high economic, social andcultural level. Unhealthy eating habits are part of risky behavior seen from adolescence. The present study wastherefore carried out to determine eating habits, level of knowledge about cancer prevention and behavior of agroup of adolescents. Methods: Data were collected using questionnaire covering eating habits and knowledgeof adolescents on prevention from cancer, and special scale (HPLP) to determine the related behavior. Threehundred sixty six of 390 students volunteered for study. Results: Eating habits and the level of cancer preventionknowledge were similar for both genders, except for the exercise issue. The mean total points of adolescents inthe Health Promotion Behavior and Subscales was 113,63. While spiritual growth had the highest score inHPLP subscale, exercise had a minimal score. Exercise was the only HPLP subscale with a statistically significantdifference between male and female genders. Conclusions: Although they have some information, the adolescentssurveyed did not have preventive skills relative to their practical life. In general in order to ensure cancerprevention and a healthy life style social, cultural and sportive activities should be encouraged and educationalprogrammes supporting these goals should be designed and applied for all stages of life, starting in earlychildhood.     

Role of Vitamin D Deficiency and Lack of Sun Exposure in the Incidence of Premenopausal Breast Cancer: a Case Control Study in Sabzevar,Iran

Background: Vitamin D has been suggested as one of the critical factors for female reproductive health withprotective activities against different cancers but there are conflicting facts regarding its role on breast cancerwithout any clear data on premenopausal cases. This study aimed to evaluate the role of vitamin D from dietarysources and sunlight exposure on the incidence of premenopausal breast cancer. Materials and Methods: Weconducted a case control study on 60 newly diagnosed premenopausal breast cancer patients and 116 normalwomen who lived in Sabzevar and surrounding villages in Razavi, Khorasan, a rural and conservative area ofIran. Results: The mean concentrations of 25-OH vitamin D in cases and controls were 15.2±8.15 vs 15.5±7/45ng/ml, both well below normal values elsewhere. In fact 50% of analyzed individuals showed very severe orsevere vitamin D deficiency and the rest (25%) were detected in suboptimal levels. Although the lack of vitaminD and calcium supplementation increased slightly the risk of premenopausal breast cancer (p=0.009, OR=1.115,CI 95%=1.049-1.187), higher prevalence of weekly egg consumption (86.66% vs 96.55%, p=0.023, OR=0.232,CI 95% 0.065-0.806) showed a slight protective role. The last but the most important risk factor was lack ofsunlight exposure because the breast cancer patients had total body coverage from sun (p=0.007, OR=10.131,CI 98% 0.314-78.102). Conclusion: This study pointed out the role of vitamin D and other possible risk factorson the development and growth of breast tumors in this special geographical region. Although this study hasrevealed the interactions between hormonal and environmental factors in this province of Iran, understandingthe deficiency pattern and its contribution to other lifestyle factors elsewhere is also necessary.     

Epidemiology of Environmental Exposure and Malignant Mesothelioma

Although the association between exposure to asbestos and malignant mesothelioma (particularly malignant pleural mesothelioma) has been well established, the health impact of environmental exposure (EE) to asbestos has been less studied. This review summarizes the most recent studies on the association between malignant mesothelioma and EE with asbestos to identify features associated with EE and quantify the association with malignant mesothelioma. There were 44 studies from 18 countries that met our selection criteria, with a considerable amount of heterogeneity in their study design, measures of exposure, and health outcomes. The male-to-female ratio was close to or less than 1 and generally lower than the ratio reported when both occupational and environmental exposures were considered. Although recent studies have continued to improve our understanding of environmental exposure to asbestos, challenges remain. We have highlighted a few new research directions, such as a need for reliable matrices to identify common and less recognized types of EE, asbestos biomarker studies specifically focusing on EE, and research on populations and geographic areas that have not been previously studied.     

Sun Exposure Makes no Discrimination based on Vitamin D Status and VDR-Foki Polymorphisms for Non-Melanoma Skin Cancers Risk in Iranian Subjects: A Case-Control Study

Background and Objective: Sunlight exposure, the main source of endogenous vitamin D synthesis, may increase the risk of non-melanoma skin cancers (NMSC) development. Vitamin D receptor (VDR) polymorphisms are associated with various malignancies. This study aimed to examine the associations between vitamin D status and VDR FokI polymorphisms in Iranian subjects with NMSC. Materials and Methods: This case-control study included 73 diagnosed cases of NMSC and 72 healthy controls from dermatology clinics at Razi Hospital, Tehran, Iran. A questionnaire was used to assess sunlight exposure. The extracted DNA from whole blood samples was genotyped and serum concentrations of 25-hydroxycalciferol (25(OH)D)) and intact parathyroid hormone (iPTH) were measured. Results: We found a significant higher duration of cumulative sunlight exposure in cases compared with controls (p<0.001). However, 25(OH)D and iPTH concentrations were not significantly different between cases and controls (30±15 vs. 29±15 ng/mL, p=0.78 and 46.0±20 vs. 40.5±23 pg/mL, p=0.14, respectively). We did not observe any significant increased risk of NMSC due to f allele, as compared with FF (OR =2.33, 95% CI 0.81-6.75, p=0.12). Conclusion: Though sunlight exposure was associated with increased NMSC risk, there were no significant associations between vitamin D status or VDR FokI polymorphisms with NMSC development in our subjects.     

Evaluation of the Level of Knowledge of Oral Cancer Among High School Students

The present study aims to determine the knowledge level of high school students regarding oral cancer. The present study included students from 20 high schools located in the city center of Kahramanmaras between 1 and 28 April 2015. The students were informed prior to the study and 2759 students who gave written consent were included in the study. The participants were administered a questionnaire that was prepared by the investigators. The questionnaire included 25 questions that were prepared using literature in order to establish the knowledge level of the students about oral cancer, and it was evaluated scoring one point to each question. There were 1711 (62.0 %) female students and 1048 (38.0 %) male students; the mean age was 16.01?±?1.09 years. The knowledge score of the male students was 7.48?±?5.15 and the knowledge score of the female students was 7.58?±?4.96. The knowledge score of the female and male participants was similar (p?=?0.605). Of the students, 2107 (76.4 %) stated that they heard the expression of oral cancer before compared to 652 (23.6 %) students stating they did not. The study found that high school students had insufficient levels of knowledge about oral cancer. There was a general lack of knowledge about oral cancer and the risks among these students.     

The Experiences of Smoking in School Children up to and Including High School Ages and the Current Status of Smoking Habits; a Survey of Male High School Students in Japan

Objective: The burden of tobacco-induced cancer is so heavy that every country should give the highest priority ‍to tobacco control in its fight against cancer. The purpose of the present study was to investigate the actual conditions ‍of tobacco smoking among boys in Japan. ‍Methods: A self-administered questionnaire survey. Two thousand and fourteen high school boys in Fukuoka ‍City, Japan, answered unsigned self-administered anonymous questionnaires about tobacco smoking. ‍Result: Among 2014 students, 10.9% were current smokers. The rates of current smokers increased with the ‍school age: 6.3% in the first grade; 11.3% in the second grade; and 15.5% in the third grade (ptrend <0.01). A total of ‍35.1% of students had the experience of smoking and 30% experienced smoking before entering high school. Of the ‍students with smoking experience, 28.6% answered that they started smoking because their friends had offered ‍them cigarettes and 52.5% of current smokers bought cigarettes from vending machines. ‍Conclusion: Health education for anti-smoking in all primary and secondary schools as well as restriction of ‍cigarette vending machines should be strongly recommended. ‍     

Association of Sun Safety Behaviors and Barriers with Sunburn History in College Students in a Region with High UV Exposure

Over five million cases of skin cancer are diagnosed each year in the United States with melanoma the third most common cancer in young adults. While publications have shown that sunburns increase the risk of developing melanoma throughout the lifetime including in adolescence and adulthood showing the importance of altering sun exposing behaviors throughout the lifetime, use of sun protection in college students remails low. In Fall 2019, an online survey of undergraduate students living on campus at a large southwestern university was conducted to determine the frequency of recent sunburns as well as sun protective behaviors and perceived knowledge of and barriers to sun protection. Associations between knowledge, behaviors, and barriers with self-reported sunburn were evaluated using logistic regression. Over 46% of 458 students reported at least one sunburn in the past three months and 21% reported having multiple sunburns in that period. Furthermore, 53% reported that they intentionally tanned their skin outdoors occasionally or more frequently, while 6.4% reported using an indoor tanning bed occasionally or more. Adjusted for skin sensitivity, recent sunburn history was associated with higher tanning activity scores and with high agreement that tanning was attractive (p < 0.01). This information can inform a more targeted series of intervention programming on the university campus.     

Knowledge and Attitudes of Medical and Non-Medical Turkish University Students about Cervical Cancer and HPV Vaccination

Background: This study was conducted to determine knowledge, attitudes and practices about cervical cancer and HPV vaccination of students studying in various faculties of Erciyes University. Materials and Methods: The study was performed among the first and fourth grade students of Medicine, Theology, Education and Economics and Administrative Sciences (FEAS) faculties of Erciyes University. It was aimed to reach 1,073 students and 718 were evaluated. A questionnaire consisting of 48 questions related to the socio-demographic characteristics, knowledge, attitude and practices about cervical cancer and HPV vaccination was administered to the students. The chi-square test and logistic regression were used for the statistical analyses. Results: Of the students, 78.3% were aware of cervical cancer, while 36.1% of them were aware of the HPV vaccine. The percentage hearing about cervical cancer and HPV vaccination was significantly higher among the students of the medical faculty than the others and among fourth grade students comparing with the first grade. The marital status and the presence of a health worker in the family had no significant impact on the knowledge level of the students. The acceptability of the HPV vaccination was low among all students. Conclusions: The knowledge levels of the university students about cervical cancer and HPV vaccination are inadequate. This deficiency is more pronounced among the non-medical students and there is no significant increase during the faculty years. Non-medical students must be provided with information about important public health issues by elective courses. HPV vaccination could provide many benefits for men and women by decreasing the morbidity and mortality of cervical, anal, and penile cancers.     

Smoking Habits and Carcinoma of the Stomach: A Case-Control Study

Over a period of 8 years, a case-control study was carried out on smoking habits in 117 patients with carcinoma of the stomach and 234 controls, and a significant association of a particular method of smoking with the site of gastric carcinoma was found in the cancer patients. Furthermore, there was a highly significant difference in method of smoking between the cancer patients and the control group. The prevalence of smoking habit in the latter was 37%, of which 26% had swallowed the smoke regularly. In contrast, the incidence of smoking habit in the cancer patients was over 56%, of which 64% had swallowed the tobacco smoke. The difference is highly significant (P < 0.001). The study also suggests that the distal part, in particular, the antrum of the stomach was affected more frequently among the smokers of the cancer patients who had swallowed the smoke regularly but the cardiac end seemed to be involved more often in the other groups of the cancer patients. These included'never-smokers,'ex-smokers and those smokers who did not swallow the smoke (P < 0.01). It is therefore concluded that the swallowing of tobacco smoke seems to influence the site of gastric carcinoma. The relative risk was six-fold higher among the smokers who did swallow the smoke compared with the 'never-smokers' of the control group.     

Knowledge Attitude and Practice of Colorectal Cancer among School Teachers in Al-Ahsa Saudi Arabia

Background: Colorectal cancer is the second leading cause of deaths among cancers affecting both men and women in the United States. Annually, about 140,000 Americans are diagnosed with colorectal cancer, and more than 50,000 people die from it. In Saudi Arabia, this cancer ranks first among men and third among women. Nevertheless, this type of cancer is one of the most preventable types of cancer. Objective: The aim of this study was to assess the level of colorectal cancer awareness among teaching staff (educators) in Al-Ahsa, Saudi Arabia. Methodology: The current cross-sectional study was conducted in teaching staff in Al-Ahsa, Eastern province, Saudi Arabia, from February 2017 to May 2017. A self-administered questionnaire was used for data collection and SPSS (version 24) was run for data analysis. Result: A total of 367 teachers (165 males and 202 females) were recruited for the present investigation. The participants aged from 25 to 55 years and most of them were married (87%). The majority had inadequate knowledge about risk factors of colon cancer. No significant difference was observed between people living in urban and rural areas regarding knowledge of risk factors for colorectal cancer (p≥0.05). Concerning colorectal cancer screening tests, 39% of men and 42% of women were unaware ; although, 12.8% of the participants reported a positive family history of colon cancer. In General, participants with higher education level had higher level of awareness on colon cancer. Conclusions: The findings of this study demonstrated that most of educators, including men and women are unaware of colon cancer risk factor. Furthermore, their knowledge of colon cancer signs, symptoms, and screening methods were inadequate. With respect to our findings, enhancement of colon cancer knowledge among educators is recommended using health education campaign in Al-Ahsa.