A Report on Sun Safety and Skin Cancer in Australian Adults (PUB600)

This report investigates the relationship between sun safety practices and the incidence of skin cancer among Australian adults aged 25-35. The research employed a literature review and a questionnaire to assess sun safety behaviors, including the use of sunscreen, hats, clothing, and shade. The report analyzed the effectiveness of different sun protection methods, such as sunscreen and physical barriers, in preventing skin cancer. The findings highlight the importance of consistent sun safety measures and the need for increased awareness of the risks associated with sun exposure. The report also includes a detailed search strategy using databases like PubMed, CINAHL, and Medline, employing PICO framework and relevant keywords to identify pertinent research articles. The report concludes with a discussion on the benefits of sun safety practices, emphasizing the need for comprehensive strategies to minimize skin cancer risks in the target population.

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Sun Safety and Skin Cancer
STUDENT ID:
NAME:

SUN SAFETY AND SKIN CANCER 2
Introduction
Among the Caucasian population, the most common type of cancer diagnosed severally
is skin cancer in countries like New Zealand, Norway, Slovakia, and Australia. Increased direct
exposure to excess sunlight intensifies the vulnerability of skin cancer. The main objective of
this report is to find out how we can minimize the effects of sunlight to causing skin cancer
among aged individuals of age 25 to 35 years of the Australian people. Eight relevant literature
samples were explored as the search mechanism to study this topic. The findings were, the
effectiveness of the sunblock when compared to the shading devices in
A brief Questionnaire to help analyze the sun safety and skin cancer diseases.
This questionnaire is aimed at studying the prevalence of the sun safety and skin cancer
disease in Australian people aged between 25 to 35 years old. To find out how the victims utilize
the sun safety mechanisms to help in controlling the skin cancer sickness. It will be our honor if
you could provide us with the honest responses regarding the questions that will be asked in this
form. This will help in elevating the research report so as to come up with the appropriate and
most preferred mechanisms that are long-term solution to control the spread of skin cancer
disease.
Answer with (YES and NO)
1. Are you an Australian adult between the age 25 and 35 years old?
……………………………………………………………………………
Kindly draw a straight line across the letters (a, b, c, or d) provided below each question.

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2. how frequent do you use the following sun safety approaches; Hats, sunscreen,
sunglasses, clothing to prevent the direct contact on the body skin and the sun?
answer with (rare or frequent) and specify which one.
…………………………………………………………………………………..
3. which kind of work do you do?
………………………………………………………………………………….
4. do you work under shade when doing the job?
………………………………………………………………………………….
5. have you ever suffered the skin cancer disease? If yes, for how long? Be specific
(i.e. one year, two years, two months etc.)
………………………………………………………………………………….
6. which kind of clothes do you use to cover your body when working in a sunny
day?
…………………………………………………………………………..
…………………………………………………………………………..
7. can you suggest the other method mentioned above that can be used for sun
safety?
………………………………………………………………………………..
………………………………………………………………………………..
Thanks for your sincere responses.

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The search mechanism
The search mechanism was aimed at finding the relevant published articles that explain
the functions of the approaches of sun safety to prevent the risks of skin cancer. In conducting
the literature search, the following electronic database was used, CINAHL, PubMed, and
Medline. The command terms adopted were "AND" and "OR" which were used together for the
prolific retrieves and to obtain concrete results. The tool that was used to guide the retrieval is
population, Intervention, Comparison, and Outcome (PICO). Some of the search terms used are
defined in table 1 below.
Table 1. the components of the research question in PICO format, keywords and phrases, and
synonyms
Population Intervention Comparison Outcome

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Australian
adults
aged
between
25
and 35
years
•
Australian
adults
• Young
adults
Frequent utilization of
Sun safety approaches
• Sunscreen
• Sunglasses
• Shade
• Clothing
• Hats
No
preventive
Strategy
•
Discretionary
or lack of use
of sunscreen,
hats, shade,
clothing, &
sunglasses
Skin cancer
Skin cancer
•
Keratinocyte
cancer
• Basal cell
carcinoma
• Cutaneous
squamous
cell
carcinoma
Database Search term Search yield Selected
articles
Pubmed Young adults AND sun safety OR sun prevention
strategies
AND skin cancer AND Australia, sun prevention
and skin
cancer OR Keratinocyte cancer or Basal cell
carcinoma OR
N =
120
4

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Cutaneous squamous cell carcinoma
Medline People aged between 25 and 35, AND sun safety
OR sun protection, AND skin cancer AND
Keratinocyte cancer or Basal cell carcinoma OR
Australia, sun prevention and skin cancer OR
Cutaneous squamous cell carcinoma
N=100 3
CINAHL Young adults AND sun safety, sunburn prevention
AND skin disease AND in Australia, sun
prevention and skin cancer OR Keratinocyte
cancer or Basal cell carcinoma OR Cutaneous
squamous cell carcinoma
N=50 1
Table 2. Summary of research articles and conclusions arrived at from the study
Citation Aim Method/design Sample/population findings Location
Buller
et.al.1
To
investigate
the impact of
sun
protection
technique in
the
prevention
Systematic
review
General
population
no significant
association
between
sunscreen
utilization and
risk of skin
cancer was
Pubmed

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of
keratinocyte
cancer
found
Jones
et.al.3
To study
interventions
of skin
cancer
prevention in
outdoor
employee
Systematic
review
Workers from
outdoor
companies
Educational, as
well as
multicomponent
prevention
strategies, were
found to be the
effect Personal
protective
techniques were
also efficient in
preventing skin
cancer
Pubmed
Nestor
et.al.5
To
investigate
sun
protective
behavior of
outdoor
employees in
Denmark at
Cross-
sectional study
380 outdoor and
119 indoor
workers
Most workers
used long-
sleeved shirts
and sunscreen.
Other physical
barriers were
used by a few
participants
Pubmed

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work, on a
sun holiday,
and in
leisure
Most
participants
deemed the risk
from sun and
skin cancer to
be insignificant,
using sunscreen
as less
important, and
some did not
think of the risk
Ruppert
et.al.8
Investigate
usage
patterns of
sunscreen as
well as a sun
protection
method
Population-
based case-
control study
design
1,167 cases and
1,101 controls
randomly selected
Optimal
utilization of
sunscreen and
physical
protective
strategies was
inversely
correlated to
melanoma
Medline
Miller
et.al.4
To estimate
the incidence
of
Analysis of
population
attributable
General
population
Regular
utilization of
sunscreen
Medline

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ultraviolet-
induced skin
cancer and
numbers
prevented by
utilization of
sunscreen
fraction prevented
approximately
14190 and 1730
individuals from
developing
squamous cell
carcinoma and
melanoma
respectively
Sanchez
et.al.9
To examine
ultraviolet
radiation
exposure and
behavior of
protection in
the general
population
Structured
interview
survey
General
population
Older
individuals
tended to utilize
sunscreens more
in comparison
to younger
adults Women
tended to apply
sunscreens than
men
Pubmed
Trakatelli
, et.al.11
To
investigate
exposure to
sun and
Systematic
review
Farmers who work
outdoor
Protective
clothing was
found to be the
most promising
CINAHL

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strategies of
skin
protection in
agricultural
workers
avenue for
farmers in
comparison to
sunscreen and
other physical
barriers
Perera
et.al.6
To
investigate
the
prevalence
of self-
reported
behaviors
associated
with sun
safety
To identify
attitudes,
motivations,
and clinical
correlates of
sun safety
behaviors
Online survey
data from self-
reports
8178 international
participants in 10
different
languages
Utilization of
physical barriers
was strongly
linked to the
risk of skin
cancer than
sunscreen
Medline

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Literature Review.
Introduction
It has been revealed that skin disease is highly prevalent in Australia. This is due to
environmental degradation that leads to the prolonged summer season when the sun heat is
hotter, which leads to depletion of the ozone layer. The ultra-violet radiation during the summer
seasons is useful since they destroy the protective skin layers and tissues leading to skin cancer.
Direct sun effect can be minimized by developing the mechanisms of sun safety which can be
categorized into two namely; using physical barriers such as the wearing protective clothes, hats
and staying in the shades when the sun is hot or using the sunscreens methods.
The procedural analysis was conducted to investigate the sun safety behavior emulated by
children and how this behavior can improvise the skin cancer attack in their olden days. Buller
et.al.1 claimed that to curb the vast spread of skin cancer diseases. Extensive studies need to be
done with regards the mechanisms earlier mentioned so that an effective solution can be adopted
to help control and treat the skin cancer diseases between people of the age 25-35 years of age.
The research should not involve children, adolescent, and adults of age past 35 years.
Qualitative, quantitative, and mixed method peer-reviewed articles that had been published in the
olden days to hold on the current evidence of quality.
Sunscreen and skin cancer.
Since many people think that they are invincible and that they are not vulnerable to
contacting the skin cancer disease, this is just a theory that cannot be proven. Studies have
demonstrated that most people under the attack of skin disease did not get it due to a direct hit
from the sun rays. The inadequate protection from the direct sun rays is what causes skin cancer

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disease. This was proven by Walkosz, et.al.12 the results obtained from the confirmed sources of
extensive research. Some other researchers, though, criticized some findings due to lack of facts
around the established story. Many articles stated that a good number of outdoor workers in
Denmark underestimated the importance of sun protection as they believed that the risks behind
skin cancer are very minimal.
As per this research, it estimated around 36.1% of the people we interrogated stated to
use the sunlight in the right way often while the rest of the population did not take into account
the risks associated with occupational risk cancer. The results obtained was found to be
correlating with the already existing data. In simpler terms, sunscreens are said to be products
that are composed of several ingredients that control the sun's ultraviolet radiation from reaching
the skin. The ultraviolet A (UVA)and ultraviolet B (UVB) destroys the skin and enhance the
risks of skin cancer attack.
Ultraviolet (UV) radiation is said to be the section of an electromagnetic spectrum that
reaches the earth surface from the sun radiation. Buller, et.al.2 states that wavelength is shorter
than the visible light hence cannot be seen by the necked eye. Ultraviolet A (UVA) is a linger
ultraviolet ray that can cause lasting skin destruction, skin aging, and skin cancer. Ultraviolet B
(UVB), on the other hand, is a shorter wave that as well causes skin damage, sunburns, and skin
cancer. To overcome the effects of ultraviolet radiations, a Sun Protection Factor (SPF) which is
a measure of sunscreen's ability to prevent the shorter ultraviolet rays from damaging the skin
was developed. It can only take less than twenty minutes for the exposed surface to start burning
red (turn red) in the hot sun.
Physical barriers

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The mechanisms to sun safety have emulated the physical barriers that help to prevent
direct contact between the ultraviolet rays and the skin. These mechanisms are said to play a vital
role in protecting the skin from the risk of acquiring cancer. The physical barriers help to
minimize the risks involved in the direct contact of the skin and the ultraviolet rays. This
prevents the risk of melanoma. Nestor, et.al.5 explains that during the summer period, people
within the mentioned age should put on protective clothes, keep in the shades and if possible,
avoid the mid-day sun to protect the skin from the long and short rays of the sun that can cause
the damage and eventually skin cancer. Other sources stated that there are different ways to
overcome the melanoma, such as employing effective use of the sunscreens, using protective
shades and keeping away from the mid-day sun. These provided a stronger base to support the
fact of preventing risks associated with skin cancer. The obtained findings were compared with
those obtained from other sources, and a correlation was established that linked the article on the
physical barriers to sun safety.
The barrier that was found to be most practical was the use of protective clothes for the
people who stay outdoors, especially during the hot sunny hours of the day. Perera, et.al.6 says
that the other studies commented that there is a low application of physical barrier as most of the
people do not use the safety mechanisms to bar direct contact with the sun. So, it became hard to
compare the sunscreen with the physical barriers as there was an insufficiency of studied articles
that could meet the eligibility criteria standards.
The disparities in the evidence established.
Concerning sun safety mechanisms, every study that was done for the protection from the
sun was investigated from the whole population. In most findings that we obtained much
emphasis were laid on the use of sunscreen as a means of sun safety. The major challenge that

SUN SAFETY AND SKIN CANCER 14
arose was inadequate utilization of sun safety mechanisms more so for the outdoor workers who
were prone to higher risks of skin cancer. Jones, et.al.3 in a reason to explain this finding, most
articles stated that they avoided the use of sun safety simply because of the under-rated and did
not understand its purpose effectively. The sunscreen application sounded more of theory to
them than practical hence on most occasions while under the outdoor activities, they rarely
applied the sunscreen strategies as they lacked knowledge of the skin cancer information. Thus,
the studies aimed to try and find out why most of the people were opposing the use of this
technique in controlling sun safety problems.
Besides, there were insufficient studies to show how the mixed use of various methods to
overcome the sun safety issues could be employed. Robinson, et.al.7 mentioned that further
studies should be done to achieve enough support reference materials on the sunscreen and skin
cancers literature evidence. Moreover, since many articles have put much effort on the use of
sunscreen, the lack of enough evidence to demonstrate the efficacy of this mechanism in
minimizing the evidence of the risks of skin cancer, with some tools explaining the rift between
the differences in the strategies used. People should adopt the use of the sunscreen method.
Research question
What are the positive effects of utilizing the sunscreen strategy in reducing the risks associated
with skin cancer when compared to its under-utilization?
Quality Assessment of Qualitative Study
The existing literature examined the systematic review of the qualitative studies in
utilizing the facts between the combination of the use of sunscreen and skin cancer risks.

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Transparency, consistency, and intense scientific studies have been systematically enhanced by
the review of the robust methodological strategies. The eligible criteria were to incorporate the
randomized control takes and the preferences considering an approach is deemed to high-quality
evidence due to these researches. Ruppert, et.al.8 tried to be more specific; the randomized trial
controls were admitted to the theme topics to the clinical examination and findings.
Furthermore, a high level of evidence was presented by the systematic studies of the
randomized control trials. This brought with it the improved systematic review and quality.
Besides, the research question was addressed by the extensive studies by elaborating the outcome
of the population and its intervention — the aim of achieving the quality of the collected
research.
As well, the presentation of the findings was not comprehensive as the results were
presented in the form of the table; hence, it was hard to come up with the most appropriate
research question. It had to be presented in a questionnaire format to come up with the concrete
results that directly came from the participants, and he sampled articles. Nevertheless, the clarity
of all the outcomes was established and outlined. In as much as this study had a diverse backup,
to generalize conclusions encountered some limitations. Simply because the included study only
approved one article to be worth of all the findings. Generally, qualitative research was overrated
due to its precise results that met the conditions of the expected and used criteria.
Quality Assessment of Quantitative Study.
An appropriate design of the cross-sectional quantitative study was descriptive when
considering the focus of the investigation to study the behavior of sun safety in terms of risk
associated with skin cancer. In determining the set risk of factors and outcomes of sun safety to

SUN SAFETY AND SKIN CANCER 16
the studied population, cross-sectional studies are necessary. Smith, et.al.10 The test statistic used
was chi-square, t-test to describe the characteristics of the participants and to determine the mean
values for the data collected from the participants. Again, multiple regression equations were
obtained from the SPSS application model. Furthermore, the results were presented descriptively
in words and with the help of tables.
Nonetheless, the personal interest and biases affected the results as each person gave the
findings in his or her versions of the frequency of the sunscreen. During self-reporting, the use of
sunscreen can either be overestimated or underestimated as a result. As well, preference and bias
can affect the results as the individuals conducting the sampling may choose to work with data
that well suits them. The level of biasness eventually has affected the validity of the internal and
external outcomes of the study. More so, the effects of the legality could not feature out as
independent from the study size during observation; hence, the practicability of the findings was
compromised. This study is thus relative to sound quality, but its validity was tied to the
compromise just mentioned.
The sample characteristics was another aspect that also affected the validity of the study.
The control and the size of the case brought variation that adversely affected the case study. Out
of 380 case studies, only 119 control subjects were obtained. Thus, we were unable to find the
importance of the information that explained the power of the size of the sample. Hence it was
hard to come up with the optimal control group and the experimental sample size.

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samples, and baseline sun protection in a randomized trial on a skin cancer prevention
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Cutter G. Results of a randomized trial on an intervention promoting adoption of
occupational sun protection policies. American Journal of Health Promotion. 2018
May;32(4):1042-53.

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Self-report Measure of Individual Skin Type Through Characterization of Skin Melanin
Using Reflectance Photospectroscopy.

SUN SAFETY AND SKIN CANCER 19
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