Background: Print media are a major source of health information. Objectives: To analyse press coverage related to skin cancer prevention. Methods: We conducted a content analysis of print media articles pertaining to skin cancer prevention, solaria and vitamin D published in Germany and Switzerland over a 1-year period between 2012 and 2013. Results: Overall, 2,103 articles were analysed. Applying sunscreen was by far the most common sun protection recommendation. A considerable number of articles on solaria and vitamin D advocated exposure to ultraviolet radiation to enhance physical appearance and vitamin D photosynthesis, often without mentioning any precaution measures. In total, 26.8% of the articles contained misleading or erroneous statements mostly related to sunscreen use and vitamin D issues. Conclusions: Print media can serve as powerful education tools to foster skin cancer prevention. However, misleading or erroneous reports may negatively impact sun-safe behaviour.

Keywords:
Skin neoplasms, Sunburn, Prevention, Ultraviolet rays, Sunscreening agents, Solaria, Vitamin D, Media, Newspapers, Magazines
1.
Lomas A, Leonardi-Bee J, Bath-Hextall F: A systematic review of worldwide incidence of nonmelanoma skin cancer. Br J Dermatol 2012;166:1069-1080.
2.
Armstrong BK, Kricker A: The epidemiology of UV induced skin cancer. J Photochem Photobiol B 2001;63:8-18.
3.
Wehner MR, Chren MM, Nameth D, Choudhry A, Gaskins M, Nead KT, Boscardin WJ, Linos E: International prevalence of indoor tanning: a systematic review and meta-analysis. JAMA Dermatol 2014;150:390-400.
4.
Dadlani C, Orlow SJ: Planning for a brighter future: a review of sun protection and barriers to behavioral change in children and adolescents. Dermatol Online J 2008;14:1.
5.
Garside R, Pearson M, Moxham T: What influences the uptake of information to prevent skin cancer? A systematic review and synthesis of qualitative research. Health Educ Res 2010;25:162-182.
6.
Mahler HI: Reasons for using and failing to use sunscreen: comparison among whites, Hispanics, and Asian/Pacific Islanders in Southern California. JAMA Dermatol 2014;150:90-91.
7.
McLeod G, Insch A, Henry J: Reducing barriers to sun protection - application of a holistic model for social marketing. Australasian Marketing J 2011;19:212-222.
8.
Hay J, Coups EJ, Ford J, DiBonaventura M: Exposure to mass media health information, skin cancer beliefs, and sun protection behaviors in a United States probability sample. J Am Acad Dermatol 2009;61:783-792.
9.
Meissner HI, Potosky AL, Convissor R: How sources of health information relate to knowledge and use of cancer screening exams. J Community Health 1992;17:153-165.
10.
O'Keefe GJ, Boyd HH, Brown MR: Who learns preventive health care information from where: cross-channel and repertoire comparisons. Health Commun 1998;10:25-36.
11.
Schwitzer G, Mudur G, Henry D, Wilson A, Goozner M, Simbra M, Sweet M, Baverstock KA: What are the roles and responsibilities of the media in disseminating health information? PLoS Med 2005;2:e215.
12.
Dixon H, Warne C, Scully M, Dobbinson S, Wakefield M: Agenda-setting effects of sun-related news coverage on public attitudes and beliefs about tanning and skin cancer. Health Commun 2014;29:173-181.
13.
Kemp GA, Eagle L, Verne J: Mass media barriers to social marketing interventions: the example of sun protection in the UK. Health Promot Int 2011;26:37-45.
14.
Geller AC, Zhang Z, Sober AJ, Halpern AC, Weinstock MA, Daniels S, Miller DR, Demierre MF, Brooks DR, Gilchrest BA: The first 15 years of the American Academy of Dermatology skin cancer screening programs: 1985-1999. J Am Acad Dermatol 2003;48:34-41.
15.
Gilchrest BA: Sun exposure and vitamin D sufficiency. Am J Clin Nutr 2008;88:570S-577S.
16.
WHO: Global solar UV Index: a practical guide. A joint recommendation of World Health Organization, World Meteorological Organization, United Nations Environment Programme and the International Commission on Non-Ionizing Radiation Protection. Geneva, World Health Organization, 2002.
17.
Albert MR, Ostheimer KG: The evolution of current medical and popular attitudes toward ultraviolet light exposure. Part 3. J Am Acad Dermatol 2003;49:1096-1106.
18.
Borner FU, Schutz H, Wiedemann P: The influence of the UV-index on attitudes toward sun exposure in the German population. J Cancer Educ 2010;25:643-649.
19.
Krebs H: Bekanntheit, Verständnis und Beachtung des UV Index. Eine Evaluationsstudie im Auftrag der Krebsliga Schweiz. Zurich, 2008. Available on request at www.krebsliga.ch.
20.
Lautenschlager S, Wulf HC, Pittelkow MR: Photoprotection. Lancet 2007;370:528-537.
21.
Surber C, Ulrich C, Hinrichs B, Stockfleth E: Photoprotection in immunocompetent and immunocompromised people. Br J Dermatol 2012;167(suppl 2):85-93.
22.
Krebsliga Schweiz: Sonnenschutz. Eine Information der Krebsliga. Bern 2015. https:// assets.krebsliga.ch/downloads/1320.pdf (accessed May 30, 2015).
23.
Bundesamt für Gesundheit: Ultraviolette Strahlung. Bern. http://www.bag.admin.ch/uv_strahlung (accessed May 30, 2015).
24.
European Skin Cancer Foundation: Sun protection. Berlin. http://www.escf-network.eu/en/patients/prevention/sun-protection.html (accessed May 30, 2015).
25.
Deutsche Krebshilfe: Die Deutsche Krebshilfe rät: Richtig mit der Sonne umgehen. Bonn. http://www.krebshilfe.de/wir-informieren/ueber-praevention-frueherk/sonne-und-hautkrebs.html (accessed May 30, 2015).
26.
Miller AJ, Tsao H: New insights into pigmentary pathways and skin cancer. Br J Dermatol 2010;162:22-28.
27.
Augustin M, Stadler R, Reusch M, Schafer I, Kornek T, Luger T: Skin cancer screening in Germany - perception by the public. J Dtsch Dermatol Ges 2012;10:42-49.
28.
Antonov D, Hollunder M, Schliemann S, Elsner P: UV exposure and protection behavior in the general population: a structured interview survey. Dermatology 2016;1:11-16.
29.
Woo DK, Eide MJ: Tanning beds, skin cancer, and vitamin D: an examination of the scientific evidence and public health implications. Dermatol Ther 2010;23:61-71.
30.
Wolpowitz D, Gilchrest BA: The vitamin D questions: how much do you need and how should you get it? J Am Acad Dermatol 2006;54:301-317.
31.
Scully M, Wakefield M, Dixon H: Trends in news coverage about skin cancer prevention, 1993-2006: increasingly mixed messages for the public. Aust NZ J Public Health 2008;32:461-466.
32.
Scully M, Makin J, Maloney S, Wakefield M: Changes in coverage of sun protection in the news: threats and opportunities from emerging issues. Health Educ Res 2014;29:378-387.
33.
Youl PH, Janda M, Kimlin M: Vitamin D and sun protection: the impact of mixed public health messages in Australia. Int J Cancer 2009;124:1963-1970.
34.
Diffey BL: When should sunscreen be reapplied? J Am Acad Dermatol 2001;45:882-885.
35.
International Standard: Cosmetics - sun protection test methods - in vivo determination of the sun protection factor (SPF). ISO 24444 2010.
36.
Lademann J, Schanzer S, Richter H, Pelchrzim RV, Zastrow L, Golz K, Sterry W: Sunscreen application at the beach. J Cosmet Dermatol 2004;3:62-68.
37.
Petersen B, Datta P, Philipsen PA, Wulf HC: Sunscreen use and failures - on site observations on a sun-holiday. Photochem Photobiol Sci 2013;12:190-196.
38.
Wright MW, Wright ST, Wagner RF: Mechanisms of sunscreen failure. J Am Acad Dermatol 2001;44:781-784.
39.
Osterwalder U, Herzog B: Sun protection factors: worldwide confusion. Br J Dermatol 2009;161(suppl 3):13-24.
40.
Loden M, Beitner H, Gonzalez H, Edstrom DW, Akerstrom U, Austad J, Buraczewska-Norin I, Matsson M, Wulf HC: Sunscreen use: controversies, challenges and regulatory aspects. Br J Dermatol 2011;165:255-262.
41.
Van der Pols JC, Williams GM, Pandeya N, Logan V, Green AC: Prolonged prevention of squamous cell carcinoma of the skin by regular sunscreen use. Cancer Epidemiol Biomarkers Prev 2006;15:2546-2548.
42.
Thompson SC, Jolley D, Marks R: Reduction of solar keratoses by regular sunscreen use. N Engl J Med 1993;329:1147-1151.
43.
Green AC, Williams GM, Logan V, Strutton GM: Reduced melanoma after regular sunscreen use: randomized trial follow-up. J Clin Oncol 2011;29:257-263.
44.
Stahl W, Sies H: Photoprotection by dietary carotenoids: concept, mechanisms, evidence and future development. Mol Nutr Food Res 2012;56:287-295.
45.
Seite S, Fourtanier A, Moyal D, Young AR: Photodamage to human skin by suberythemal exposure to solar ultraviolet radiation can be attenuated by sunscreens: a review. Br J Dermatol 2010;163:903-914.
46.
Sheehan JM, Potten CS, Young AR: Tanning in human skin types II and III offers modest photoprotection against erythema. Photochem Photobiol 1998;68:588-592.
47.
Autier P, Dore JF, Breitbart E, Greinert R, Pasterk M, Boniol M: The indoor tanning industry's double game. Lancet 2011;377:1299-1301.
48.
Lim HW, James WD, Rigel DS, Maloney ME, Spencer JM, Bhushan R: Adverse effects of ultraviolet radiation from the use of indoor tanning equipment: time to ban the tan. J Am Acad Dermatol 2011;64:893-902.
49.
Miyamura Y, Coelho SG, Schlenz K, Batzer J, Smuda C, Choi W, Brenner M, Passeron T, Zhang G, Kolbe L, Wolber R, Hearing VJ: The deceptive nature of UVA tanning versus the modest protective effects of UVB tanning on human skin. Pigment Cell Melanoma Res 2011;24:136-147.
50.
Kannan S, Lim HW: Photoprotection and vitamin D: a review. Photodermatol Photoimmunol Photomed 2014;30:137-145.
51.
Norval M, Wulf HC: Does chronic sunscreen use reduce vitamin D production to insufficient levels? Br J Dermatol 2009;161:732-736.
52.
Schmitt J, Seidler A, Diepgen TL, Bauer A: Occupational ultraviolet light exposure increases the risk for the development of cutaneous squamous cell carcinoma: a systematic review and meta-analysis. Br J Dermatol 2011;164:291-307.
53.
Bauer A, Diepgen TL, Schmitt J: Is occupational solar ultraviolet irradiation a relevant risk factor for basal cell carcinoma? A systematic review and meta-analysis of the epidemiological literature. Br J Dermatol 2011;165:612-625.
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2015
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