Medical College, Rush University Medical Center, Chicago, IL, USA.
Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
J Prev (2022). 2024 Dec;45(6):957-972. doi: 10.1007/s10935-024-00795-x. Epub 2024 Aug 7.
Health literacy is essential for individuals to access, understand, and utilize information and services to inform health related decisions and actions. As one of the most diagnosed and preventable forms of cancer, skin cancer disease risk can be reduced through preventative behavior. Currently, there is no focused study looking specifically at health literacy and skin cancer. An understanding of how health literacy affects skin cancer-related preventive behaviors can improve current practices in skin cancer prevention.
To systematically identify, synthesize, and summarize findings on the role of health literacy in skin cancers (including cutaneous squamous cell carcinoma, basal cell carcinoma, and melanoma), with a focus on preventive behaviors using studies that utilized quantifiable health literacy measurements.
A literature search was performed by searching PubMed, Embase, PsycINFO, and CINAHL from inception until September 26, 2023 to identify cross-sectional, case-control, cohort, or randomized controlled studies that investigated the association between health literacy and skin cancer prevention and diagnosis.
Health literacy levels varied across geographic regions, specific populations, and ethnicities. Most of the included studies found a positive association between higher health literacy and better skin cancer preventative behaviors. This included sun-protective behaviors such as: wearing sleeved shirts or shirts with collars, using gloves, covering head and face, limiting sun exposure, more sunscreen use, and less sunbathing or indoor tanning. Higher health literacy was associated with increased likelihood to engage in genetic testing and less family influence on health in one study which assessed determinants of interest in skin cancer genetic testing. Another study investigating family communication about skin cancer found that higher health literacy was associated with increased family communication regarding general cancer risk. One sun protection interventional education program was effective at increasing participants' knowledge, awareness of skin cancer risk, willingness to change sun protection, and use of sun protection, but results varied between ethnic groups.
Skin cancer-related educational interventions can be effective in improving health literacy and potentially lessen the impact of skin cancer through positive behavior modification, early detection, and disease knowledge and awareness. Interventions need to be tailored to its target population to maximize effectiveness due to the varying baseline of health literacy identified across different geographic and ethnic groups. Protocol Registration PROSPERO CRD42022340826.
健康素养对于个人获取、理解和利用信息和服务以做出与健康相关的决策和采取相关行动至关重要。皮肤癌作为最常见的诊断和可预防的癌症之一，可以通过预防性行为来降低其发病风险。目前，尚无专门针对健康素养与皮肤癌的研究。了解健康素养如何影响皮肤癌相关的预防行为，可以改善皮肤癌预防的现行措施。
系统地识别、综合和总结健康素养在皮肤癌（包括皮肤鳞状细胞癌、基底细胞癌和黑色素瘤）中的作用，重点关注使用可量化健康素养测量方法的预防行为。
通过检索 PubMed、Embase、PsycINFO 和 CINAHL，从建库到 2023 年 9 月 26 日，对横断面、病例对照、队列或随机对照研究进行了文献检索，以确定调查健康素养与皮肤癌预防和诊断之间关系的研究。
健康素养水平因地理位置、特定人群和种族的不同而有所差异。大多数纳入的研究发现，较高的健康素养与更好的皮肤癌预防行为之间存在正相关关系。这包括防晒行为，如：穿着长袖衬衫或有领衬衫、使用手套、遮盖头部和面部、限制日晒时间、更多地使用防晒霜、减少日光浴或室内晒黑。在一项评估皮肤癌遗传检测兴趣决定因素的研究中，较高的健康素养与进行基因检测的可能性增加以及家庭对健康的影响减少有关。另一项关于家庭间皮肤癌沟通的研究发现，较高的健康素养与增加家庭对一般癌症风险的沟通有关。一项关于防晒的保护干预教育计划在提高参与者的知识、对皮肤癌风险的认识、改变防晒行为的意愿以及使用防晒产品方面是有效的，但结果因不同的种族群体而有所不同。
皮肤癌相关的教育干预措施可以通过积极的行为改变、早期发现和疾病知识及意识来提高健康素养，从而减轻皮肤癌的影响。由于不同地理位置和种族群体的健康素养基线存在差异，干预措施需要针对目标人群进行调整，以最大限度地提高其效果。注册号：PROSPERO CRD42022340826。
