br Introduction Solar ultraviolet radiation UVR

Introduction Solar ultraviolet GSK461364 (UVR) is the most common environmental cause of the vast majority of skin disorders including skin cancer. Epidemiological studies have disclosed a strong association between solar UVR and all major types of skin cancer. Although many factors such as advanced age, low Fitzpatrick skin types, and male sex have been associated with an increased risk of developing skin cancer, unprotected UVR exposure has been reported as the single most important environmental risk factor. Many epidemiological studies in the literature suggest that UVR from sun exposure and sunburns at early ages are associated with skin cancers in adulthood. It was reported that a history of sunburn in early life almost doubles the risk of developing melanoma in adulthood. The incidence of skin cancer is increasing in the world, hence, sun protection education is becoming crucial. Ankara, the capital of Turkey, has a semiarid or steppe climate with hot, dry summers and cold, snowy winters. The average temperature is 23°C in summer (minimum temperature 4.7°C and maximum temperature 41.0°C). The average UV index value was 8.6 in summer 2012 and 5.0 (minimum 0.4 and maximum 9.9) throughout the year.
Materials and methods
Discussion Although a high-level of acceptance of the necessity of sun protection by students was determined by our questionnaire (74.2%), the behavior of the students\' group was shown to be unsatisfactory. The prevalence of sunscreen usage among the adolescents in our study was only 41.8%. This prevalence was lower than that found in similar studies reported from Thailand (72.7%), Australia (66.7%), Italy (78.7%), Brazil (74.3%), and Switzerland (80.6%). The percentage that we found was higher than that reported in only one study carried out in Singapore (22%). We found no difference between sexes, although there was a female predominance in sunscreen usage in the literature. The percentage of familial cancer history in the students was lower (3.1%) than that reported in a previous study from Brazil (12.7%). There was no significant difference in sunscreen use between students with and without a familial history of cancer (66.7% vs. 41.9%, p = 0.137). Sunscreen use was significantly statistically higher in teachers with a familial cancer history (55.6 % vs. 85.3%, p = 0.021). We found no association between sunburn history and skin types in both groups, although the previous studies in the literature reported an association. Proper use of a sunscreen product with an SPF of 30 before sun exposure can prevent sun damage, as reported in the literature. Our study disclosed that the majority of the students did not know how much SPF was sufficient for sun damage prevention, and the teachers believed that a higher SPF (>30) could offer better protection. Reinau et al reported that, in Switzerland, only 12.3% of the students chose the answer “I don\'t know”. SPF value was also the most significant cause of selection of a sunscreen for students and teachers in our study. The incidence of skin cancer in Turkey was 18.9/100,000 in 2005. In 2006, the estimated age-specific and age-adjusted incidence rates for all types of cancers, excluding nonmelanoma skin cancers, were 210.1/100,000 in males and 129.4/100,000 in females. Skin cancer was among 10 most frequent cancer types in Turkey. According to the data provided by KETEM (Cancer Early Diagnosis Screening and Training Center), skin cancer was the fourth most common cancer type with an incidence rate of 9.14/100,000 in Ankara in 2004. In 2009, although the skin cancer incidence rate for the population between 15 years and 19 years of age was 0.8 [per 100,000 of the total population (6,234,620)], it was 7.1 in the 35–39-year age range [per 100,000 of the total population (5,505,313)]. Consequently, the population in the 35–39-year age range had an 8.87-times higher crude skin cancer rate in 2009.