Abstract
Background: Switzerland experiences the highest incidence of cutaneous malignant melanoma in Europe and rates are highest in the western (French-speaking) part of Switzerland. However, despite prevention campaigns for about 30 years and the increased risk of melanoma with sun overexposure during childhood, little is known about sun-related knowledge and attitudes of Swiss children.
Objectives: To investigate schoolchildren knowledge and sources of information about the adverse health effects of ultraviolet (UV) radiation, attitude towards a suntan and parental influence in a western canton of Switzerland (Neuchâtel).
Methods: All pupils from 5th, 8th and 11th grades (average ages of 9, 12 and 15, respectively) in the 18 primary (5th grade, n=431) and secondary (8th and 11th grades, n=837) public schools of La Chaux-de- Fonds were surveyed during regular school classes. Response rate was 91% (1154/1268). Descriptive statistics and multivariate logistic regression analyses were performed to assess predictors of suntan preferences.
Results: Swiss children had an overall high sun-related knowledge. Eight out of 10 knew about the risk of skin cancer and could recognize the most susceptible skin phototype. The level of knowledge increased significantly with age. Girls, older children (11th grade), fair-skinned subjects and those who reported preferring a tanned skin obtained the highest knowledge score. The main channel of information about UV radiation and sun protection was parents (76%), followed by school (11%) and media (9%). Seeking a suntan was associated with children of skin type III-IV, of higher sun-related knowledge and coming from families of lower socio-professional status (SPS). Parental sensitization
(56%) and encouragement (61%) towards sun protective behaviours was more common among fair-skinned children and children coming from higher SPS.
Conclusions: The high awareness of skin cancer risk among Swiss schoolchildren does not systematically translate into appropriate attitude. Changing the current pro-tan attitude remains a crucial challenge in order to improve children's sun behaviour. Community wide intervention programs involving parents, teachers, peers and primary care clinicians could be considered for Swiss skin cancer prevention campaigns.