Irregular use of sunscreen and associated factors in adults and older people: a population-based study in Southern Brazil
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2024.212903Keywords:
Sunscreens, Skin neoplasms, Melanoma, Ultraviolet raysAbstract
Introduction: The southern region leads skin cancer statistics in Brazil, with multiple factors related to this predisposition. Ultraviolet radiation is the main modifiable risk factor, and regular use of sunscreens has proven effective in reducing risk. Despite this, the prevalence of irregular sunscreen use has been higher than desired. Objective: To evaluate the association between irregular sunscreen use and sociodemographic, behavioral, and health characteristics in adults and older individuals. Method: A cross-sectional population-based study conducted in 2019 with adult residents in the urban area of Criciúma, state of Santa Catarina, Brazil. The outcome variable was irregular use of sunscreens. Exposure variables included sex, age, skin color, education, income, paid work, smoking, household registration in a Primary Health Care unit, access to supplementary health insurance, preventive medical and dental visits in the last year, walking in leisure time, commuting on foot or by bicycle, sufficient physical activity, personal history of cancer of any organ and the skin. To assess the association between irregular sunscreen use and these variables, crude and adjusted analyses were performed using Poisson Regression with a significance level of 5%. Results: In total, 820 individuals were studied. The prevalence of irregular sunscreen use was 52.8%. Factors associated with an increased prevalence of irregular sunscreen use were: male sex (PR 1.57; 95%CI 1.39-1.77), smoking (PR 1.19; 95%CI 1.03-1.37), being 60 years or older (PR 1.62; 95%CI 1.26-2.09), and lower education (inverse linear trend: p<0.001). On the other hand, having supplementary health insurance (PR 0.84; 95%CI 0.71-0.99) and walking in leisure time (PR 0.76; 95%CI 0.64-0.90) were protective factors. Conclusion: This study allowed us to identify the profile of individuals at higher risk of irregular sunscreen use, representing a potential health benefit by better targeting strategies for preventing skin cancer in older populations and adults.
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Schalka S, Steiner D, Ravelli FN, Steiner T, Terena AC, Marçon CR, et al. Consenso Brasileiro de Fotoproteção. An Bras Dermatol. 2014;89:01–76.
IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Solar and Ultraviolet Radiation. In: IARC Monographs on the Evaluation of Carcinogenic Risks to Humans [Internet]. Lyon (FRC): World Health Organization; 1992. Available from: https://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-The-Identification-Of-Carcinogenic-Hazards-To-Humans/Solar-And-Ultraviolet-Radiation-1992. Acesso em 04/08/2020.
IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Radiation - A Review of Human Carcinogens. In: IARC Monographs on the Evaluation of Carcinogenic Risks to Humans [Internet]. Lyon (FRC): World Health Association; 2012. Available from: https://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-The-Identification-Of-Carcinogenic-Hazards-To-Humans/Radiation-2012. Acesso em 04/08/2020.
Rembielak A, Ajithkumar T. Non-Melanoma Skin Cancer – An Underestimated Global Health Threat? Clin Oncol [Internet]. 2019;31(11):735–7. Available from: https://doi.org/10.1016/j.clon.2019.08.013
Instituto Nacional Do Câncer. Estimativa 2020: Incidência de Câncer no Brasil. INCA, Rio de Janeiro. 2020. Disponível em: < https://www.inca.gov.br/>. Acesso em: 13 jul. 2020.
Instituto Nacional Do Câncer. Mortalidade por Câncer no Brasil, 2019: INCA, Rio de Janeiro. 2019. Disponível em: < https://www.inca.gov.br/>. Acesso em: 13 jul. 2020.
Olsen CM, Wilson LF, Green AC, Bain CJ, Fritschi L, Neale RE, et al. Cancers in Australia attributable to exposure to solar ultraviolet radiation and prevented by regular sunscreen use. Aust N Z J Public Health. 2015;39(5):471–6.
Olsen CM, Wilson LF, Green AC, Biswas N, Loyalka J, Whiteman DC. How many melanomas might be prevented if more people applied sunscreen regularly? Br J Dermatol. 2018;178(1):140–7.
Mulliken JS, Russak JE, Rigel DS. The Effect of Sunscreen on Melanoma Risk. Dermatol Clin [Internet]. 2012;30(3):369–76. Available from: http://www.sciencedirect.com/science/article/pii/S0733863512000344
Cardoso MG. Transformando a capital do carvão em cidade das etnias: o processo de transformação da identidade urbana de Criciúma / SC no período de seu centenário ( 1980 ). Textura [Internet]. 2007;16:127–41. Available from: http://periodicos.unesc.net/historia/article/download/423/431. Acesso em 03/08/2020.
Silva ES da, Dumith SC. Non-use of sunscreen among adults and the elderly in southern Brazil. An Bras Dermatol [Internet]. 2019;94(5):567–73. Available from: https://doi.org/10.1016/j.abd.2018.10.002. Acesso em 29/06/2020.
Duquia RP, Baptista Menezes AM, Reichert FF, de Almeida HL. Prevalence and associated factors with sunscreen use in Southern Brazil: A population-based study. J Am Acad Dermatol [Internet]. 2007;57(1):73–80. Available from: https://www-sciencedirect.ez318.periodicos.capes.gov.br/science/article/pii/S0190962207005464?via%3Dihub. Acesso em 30/06/2020.
Silva ES da, Tavares R, Paulitsch F da S, Zhang L. Use of sunscreen and risk of melanoma and non-melanoma skin cancer: a systematic review and meta-analysis. Eur J Dermatology. 2018;28(2):186–201.
Ghiasvand R, Lund E, Edvardsen K, Weiderpass E, Veierød MB. Prevalence and trends of sunscreen use and sunburn among Norwegian women. Br J Dermatol. 2015;172(2):475–83.
Holman DM, Ding H, Freeman MB, Shoemaker ML. Association between Sun Protection Behaviors and Sunburn among U.S. Older Adults. Gerontologist. 2019;59:S17–27.
Williams SN, Dienes KA. Sunscreen sales, socio-economic factors, and Melanoma incidence in Northern Europe: A population-based ecological study. SAGE Open. 2014;4(4).
Instituto Brasileiro De Geografia E Estatística. Cidades e Estados. IBGE, Rio de Janeiro. 2020. Disponível em: <https://www.ibge.gov.br/cidades-e-estados/sc/criciuma.html>. Acesso em: 17/09/2020.
Lomas A, Leonardi-Bee J, Bath-Hextall F. A systematic review of worldwide incidence of nonmelanoma skin cancer. Br J Dermatol. 2012;166(5):1069–80.
Cardoso FA de M e. S, Mesquita GV, Campelo V, e Martins M do C de C, Almeida CAPL, Rabelo RS, et al. Prevalence of photoprotection and its associated factors in risk group for skin cancer in Teresina, Piauí. An Bras Dermatol. 2017;92(2):206–10.
Green AC, Williams GM, Logan V, Strutton GM. Reduced melanoma after regular sunscreen use: Randomized trial follow-up. J Clin Oncol. 2011;29(3):257–63.
Hughes MCB, Williams GM, Baker P, Green AC. Sunscreen and prevention of skin aging: A randomized trial. Ann Intern Med. 2013;158(11):781–90.
Young AR, Claveau J, Rossi AB. Ultraviolet radiation and the skin: Photobiology and sunscreen photoprotection. J Am Acad Dermatol. 2017;76(3):S100–9.
Gavin A, Boyle R, Donnelly D, Donnelly C, Gordon S, McElwee G, et al. Trends in skin cancer knowledge, sun protection practices and behaviours in the Northern Ireland population. Eur J Public Health. 2012;22(3):408–12.
Holman DM, Berkowitz Z, Guy GP, Hawkins NA, Saraiya M, Watson M. Patterns of sunscreen use on the face and other exposed skin among US adults. J Am Acad Dermatol [Internet]. 2015;73(1):83-92.e1. Available from: http://dx.doi.org/10.1016/j.jaad.2015.02.1112
Seité S, del Marmol V, Moyal D, Friedman AJ. Public primary and secondary skin cancer prevention, perceptions and knowledge: an international cross-sectional survey. J Eur Acad Dermatology Venereol. 2017;31(5):815–20.
Griffith DM, Gilbert KL, Bruce MA, Jr RJT. Men’s Health in Primary Care. Men’s Heal Prim Care. 2016;
McKenzie C, Rademaker AW, Kundu R V. Masculine norms and sunscreen use among adult men in the United States: A cross-sectional study. J Am Acad Dermatol [Internet]. 2019;81(1):243–4. Available from: http://dx.doi.org/10.1016/j.jaad.2018.11.053
Alexandre C, Alencar G De, Maia LP, Geral R, Rgp P. Perfil socioeconômico dos pescadores brasileiros-Socioeconomic profile of the Brazilian fishermen. 2011;44(1100):12–9.
Fernandes ÂCP, Vaz AB. Perfil do índice de massa corporal de trabalhadores de uma empresa de construção civil TT - Profile of body mass index of workers from a construction company. J Heal Sci Inst [Internet]. 2012;30(2):144–9. Available from: http://www.unip.br/comunicacao/publicacoes/ics/edicoes/2012/02_abr-jun/V30_n2_2012_p144-149.pdf
MATTEI. Novo retrato da agricultura familiar em Santa Catarina. Encontro Econ Catarinense Anais. 2010;4.
Luong J, Davis RE, Chandra A, White AE, Harber ID, Engel AA, et al. A cross-sectional survey of prevalence and correlates of sunscreen use among a rural Tri-State Appalachian population. Arch Dermatol Res [Internet]. 2020;1–4. Available from: https://doi.org/10.1007/s00403-020-02072-3
Freedman A, Nicolle J. Social isolation and loneliness: The new geriatric giants Approach for primary care. Can Fam Physician. 2020;66(3):176–82.
Menezes RL de, Bachion MM, Souza JT de, Nakatani AYK. Estudo longitudinal dos aspectos multidimensionais da saúde de idosos institucionalizados. Rev Bras Geriatr e Gerontol. 2011;14(3):485–96.
Cantalino JLR, Scherer MD dos A, Soratto J, Schäfer AA, Anjos DSO dos. Satisfação dos usuários em relação aos serviços de Atenção Primária à Saúde no Brasil. Rev Saude Publica [Internet]. 2021 May 17;55(1):22. Available from: https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-019-1194-z
Bocquier A, Fressard L, Legleye S, Verger P, Peretti-Watel P. Social Differentiation of Sun-Protection Behaviors: The Mediating Role of Cognitive Factors. Am J Prev Med [Internet]. 2016;50(3):e81–90. Available from: http://dx.doi.org/10.1016/j.amepre.2015.07.040
Brasil. Ministério da Saúde, Secretaria de Vigilância em Saúde, Departamento de Análise em Saúde e Vigilância de Doenças não Transmissíveis. – Brasília: Ministério da Saúde, 2020. Disponível em https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/svsa/vigitel/relatorio-vigitel-2020-original.pdf
Moreira LB, Fuchs FD, Moraes RS, Bredemeir M, Cardozo S. Prevalência de tabagismo e fatores associados em área metropolitana da região Sul do Brasil. Rev Saude Publica. 1995;29(1):46–51.
Teixeira IP, Nakamura PM, Kokubun E. Prática de caminhada no lazer e no deslocamento e associação com fatores socioeconômicos e ambiente percebido em adultos. Rev Bras Cineantropometria e Desempenho Hum. 2014;16(3):345–58.
Rogers HW, Weinstock MA, Feldman SR, Coldiron BM. Incidence estimate of nonmelanoma skin cancer (keratinocyte carcinomas) in the us population, 2012. JAMA Dermatology. 2015;151(10):1081–6.
Fitzpatrick TB. The Validity and Practicality of Sun-Reactive Skin Types I Through VI. Arch Dermatol [Internet]. 1988;124(6):869–71. Available from: https://jamanetwork.com/journals/jamadermatology/article-549509. Acesso em 03/08/2020.
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Copyright (c) 2024 Sergio Emerson Sasso, Fernanda de Oliveira Meller, Micaela Rabelo Quadra, Sofia Garbin Petry, Antônio Augusto Schäfer
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