Recommendations From a Chinese-Language Survey of Knowledge and Prevention of Skin Cancer Among Chinese Populations Internationally: Cross-sectional Questionnaire Study (Preprint)

Abstract

BACKGROUND There is a paucity of studies assessing awareness and prevention of skin cancer among Chinese populations. OBJECTIVE To compare attitudes and practices regarding skin cancer risks and prevention between Chinese Asians and North American Chinese and between Fitzpatrick scores. METHODS A cross-sectional, internet-based, 74-question survey in Chinese was conducted focusing on Han Chinese participants internationally. The survey included Likert-type scales and multiple-choice questions. All participants were required to read Chinese and self-identify to be at least 18 years of age and Chinese by ethnicity, nationality, or descent. Participants were recruited online over a 6-month period from July 2017 through January 2018 via advertisements in Chinese on popular social media platforms: WeChat, QQ, Weibo, Facebook, and Twitter. RESULTS Of the 113 completed responses collected (participation rate of 65.7%), 95 (84.1%) were ethnically Han Chinese, of which: 93/95 (96.9%) were born in China, and 59/95 (62.1%) were female. The mean age (SD) of these 95 participants was 35.8 (13.3) years; 72/95 (75.8%) participants were born after 1975. Few but more North American Chinese that Chinese Asians received annual skin checks (4.2% vs 0%, p=0.0086) and believe that their clinician provided adequate sun safety education (43.3% vs 23.1%, p=0.0441). Participants with higher Fitzpatrick scores less frequently received sun safety education from a clinician (11.8% vs 36.1%, p=0.0154). More participants with lower Fitzpatrick scores use sunscreen (67.2% vs 47.1%, p=0.0546), but alternative sun protection usage rates are similar across groups. CONCLUSIONS Cultural differences and Fitzpatrick scores can affect knowledge and practices with respect to sun protection and skin cancer among Chinese Asians and North American Chinese communities. Trends and gaps in knowledge were identified, and several aims for educational programs were developed.