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Journals / Etkili Hemşirelik Dergisi / 2026 / Cilt: 19 Sayı: 4

Sun Protection Behaviors of Adolescents Diagnosed with Cancer and Their Healthy Peers

Kanser Tanısı Alan Adölesanların ve Sağlıklı Akranlarının Güneşten Korunma Davranışları

Gülcihan Arkan Üner(İZMİR DEMOKRASİ ÜNİVERSİTESİ)0000-0002-6085-5831
Aslı Akdeniz Kudubeş(BİLECİK ŞEYH EDEBALİ ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ, HEMŞİRELİK BÖLÜMÜ, HEMŞİRELİK PR.)
İlknur Bektaş(İZMİR BAKIRÇAY ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ)0000-0001-8048-9501
Pages
630–655
Publication Date
2026-10-15
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Results : It was found that there was a difference between the mean scores of ADC and their healthy peers in stages of change in sun protection and sunscreen use, the total and subscale scores of SPBS and SES, and the mean scores of pros and cons dimensions of DBS for sun protection.

📌 3 Key Takeaways

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Objective & Hypothesis:Background: Skin cancer is a major public health problem worldwide.
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Key Findings & Data:Methods: This descriptive, cross-sectional, and comparative study was conducted between December 2020 and December 2021 with 514 adolescents, including 230 adolescents were diagnosed with cancer and 284 healthy adolescents.
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Conclusion & Impact:Results : It was found that there was a difference between the mean scores of ADC and their healthy peers in stages of change in sun protection and sunscreen use, the total and subscale scores of SPBS and SES, and the mean scores of pros and cons dimensions of DBS for sun protection.
🔬Design:Araştırma Makalesi
📍Scope:2020 Verileri
⚙️Variables:Adölesan · Kanser tanılı adölesan · Deri Kanseri

Abstract

Background: Skin cancer is a major public health problem worldwide. It is important to determine adolescents’ sun protection behaviors and develop protective behaviors to prevent skin cancer and sun-related skin problems that may occur in later life. Objectives: The aim of this study was to evaluate the sun protection self-efficacy, decision balance perceptions, and sun protection behaviors of adolescents diagnosed with cancer (ADC), the factors affecting these behaviors, and the difference between the variables in ADC and their healthy peers. Methods: This descriptive, cross-sectional, and comparative study was conducted between December 2020 and December 2021 with 514 adolescents, including 230 adolescents were diagnosed with cancer and 284 healthy adolescents. The data were collected using the Identifying Information Form, The Sun Protection Stage of Change and Sunscreen Use Stage of Change, The Sun Protection Behavior Scale (SPBS), The Sun Protection Decisional Balance Scale (DBS) and The Sun Protection Self-Efficacy Scale (SES). Results : It was found that there was a difference between the mean scores of ADC and their healthy peers in stages of change in sun protection and sunscreen use, the total and subscale scores of SPBS and SES, and the mean scores of pros and cons dimensions of DBS for sun protection. Conclusions: The results of this study show that adolescents diagnosed with cancer have better sun protection behaviors than their healthy peers. It is recommended that healthcare providers implement sun protection programs for the development and continuity of primary and secondary prevention behaviors in prevention of skin cancer. Keywords: Adolescent, Adolescent Diagnosed with Cancer, Skin Cancer, Sun Protection, Sunscreen

Özet

Giriş: Deri kanseri tüm dünyada önemli bir halk sağlığı sorunudur. Özellikle ileriki yaşlarda meydana gelebilecek deri kanseri ve güneşe bağlı cilt sorunlarının önlenmesinde adölesanların güneşten korunma davranışlarının belirlenmesi ve koruyucu davranışlarının geliştirilmesi önemlidir. Amaç: Bu çalışmanın amacı kanser tanılı adölesanların güneşten korunma özyeterliliklerini, karar denge algılarını ve güneşten korunma davranışlarını, bu davranışları etkileyen faktörleri ve kanser tanılı adölesanlar ve sağlıklı akranlarında değişkenler arasındaki farkı değerlendirmektir. Yöntem: Bu tanımlayıcı, kesitsel ve karşılaştırmalı çalışma Aralık 2020-Aralık 2021 tarihleri arasında kanser tanılı 230 ve sağlıklı 284 olmak üzere 514 adölesan ile yürütülmüştür. Veriler, Tanıtıcı Bilgi Formu, Güneşten Korunma Değişim Aşamaları, Güneş Koruyucu Kullanma Değişim Aşamaları, Güneşten Korunma Davranış Ölçeği, Güneşten Korunma Karar Dengesi Ölçeği, Güneşten Korunma Öz Yeterlilik Ölçeği ile toplanmıştır. Bulgular: Kanser tanılı adölesanlar ile sağlıklı akranlarının güneşten korunma ve güneş koruyucu kullanma değişim aşamaları arasında, Güneşten Korunma Davranış Ölçeği ve Güneşten Korunma Özyeterlilik Ölçeği toplam ve alt boyut ve Güneşten Korunma Karar Dengesi Ölçeği zarar ve yarar boyut puan ortalamaları arasında fark olduğu saptanmıştır. Sonuç: Bu çalışmanın bulguları kanser tanılı adölesanların güneşten korunmaya yönelik davranışları açısından sağlıklı akranlarından daha iyi bir düzeyde olduklarını göstermektedir. Deri kanserinin önlenmesinde birincil ve ikincil korunma davranışlarının geliştirilmesi ve sürekliliği için sağlık hizmeti sağlayıcılarının güneşten korunma programlarının uygulanması önerilmektedir. Keywords: Adölesan, Kanser tanılı adölesan, Deri Kanseri, Güneşten Korunma, Güneş Koruyucu

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Cite This Article

Üner, G. A., Kudubeş, A. A., Bektaş, İ. (2026). Sun Protection Behaviors of Adolescents Diagnosed with Cancer and Their Healthy Peers. Etkili Hemşirelik Dergisi, Cilt: 19 Sayı: 4, 630–655. https://doi.org/10.46483/jnef.1776064

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References (68)

  1. Abraham, O., Rosenberger, C. A., LeMay, S. M. & Bittner, S. J. (2021). Adolescents’ perceptions about cancer and preferences for cancer education. Cancer Control, 28, 1–12. https://doi.org/10.1177/10732748211036057
  2. Aggarwal, P., Knabel, P. & Fleischer, A. B. (2021). United States burden of melanoma and non-melanoma skin cancer from 1990 to 2019. Journal of the American Academy of Dermatology, 85, 388–395. https://doi.org/10.1016/J.JAAD.2021.03.109
  3. Akdeni̇z Kudubeş, A., Bektaş, M. & Karakurt, S. (2021). The effect of high school students’ self-efficacy and perceptions for sun protection on their sun protection behaviors. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 14, 124–133. https://doi.org/10.46483/DEUHFED.767796
  4. Altunkürek, Ş. Z. & Kaya, E. (2020). The effect of sun protection self-efficacy on sun protection behavior of 8th grade students in a middle school in Ankara. University of Health Sciences Journal of Nursing, 2(3), 137-144. https://doi.org/10.48071/sbuhemsirelik.772605
  5. Altunkurek, S. Z. & Kaya, E. (2021). Parents’ knowledge and understanding of skin cancer and skin self-examination and behaviors to protect their children from the sun. European Journal of Oncology Nursing, 50, 101884. https://doi.org/10.1016/J.EJON.2020.101884
  6. Austin, M. T., Xing, Y., Hayes-Jordan, A. A., Lally, K. P., & Cormier, J. N. (2013). Melanoma incidence rises for children and adolescents: an epidemiologic review of pediatric melanoma in the United States. Journal of pediatric surgery, 48(11), 2207-2213. https://doi.org/10.1016/j.jpedsurg.2013.06.002
  7. Aygun, O. & Ergun, A. (2014). Decisional balance and self-efficacy for sun protection: Measurement among Turkish adolescents. Nursing Research, 63, 309–319. https://doi.org/10.1097/NNR.0000000000000048
  8. Aygun, O. & Ergun, A. (2015). Validity and reliability of Sun Protection Behavior Scale among Turkish adolescent population. Asian Nursing Research, 9, 235–242. https://doi.org/10.1016/J.ANR.2015.04.006
  9. Aygün, Ö. & Ergün, A. (2016). Sakarya ilinde bulunan 6-8. Sınıf ortaokul öğrencilerinin güneşten korunma davranışları. TAF Preventive Medicine Bulletin, 15, 312–321. https://doi.org/10.5455/PMB.1-1449869466
  10. Aygün, Ö. & Ergun, A. (2018). The Impact of sun protection program on the sun protection behavior of adolescents. Clinical and Experimental Health Sciences, 8, 166–174. https://doi.org/10.5152/CLINEXPHEALTHSCI.2017.588
  11. Aygun, O. & Karayağız Muslu, G. (2021). The effect of a school-based sun protection program on students’ sun protection behavior in Turkey. Journal of Pediatric Nursing, 59, e61–e69. https://doi.org/10.1016/J.PEDN.2021.01.030
  12. Ayvaz, H. H., Acar, H. T., Ercan, S. & Çetin, C. (2021). Investigation of the knowledge level, attitudes, and behaviors about sun protection and sunscreen in adolescent athletes. Turkderm-Turkish Archives of Dermatology and Venereology, 55, 75–80. https://doi.org/10.4274/TURKDERM.GALENOS.2020.62372
  13. Balla, J. & Hagger, M. S. (2024). Protection motivation theory and health behaviour: conceptual review, discussion of limitations, and recommendations for best practice and future research. Health Psychology Review, 19(1), 145–171. https://doi.org/10.1080/17437199.2024.2413011
  14. Braam, K. I., Overbeek, A., Kaspers, G. J. L., Ronckers, C. M., Schouten‐van Meeteren, A. Y. N., Van Dulmen‐Den
  15. Broeder, E., & Veening, M. A. (2012). Malignant melanoma as second malignant neoplasm in long‐term childhood cancer survivors: a systematic review. Pediatric blood & cancer, 58(5), 665-674. https://doi.org/10.1002/pbc.24023
  16. Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Routledge. https://doi.org/10.4324/9780203771587
  17. Diao, D. Y. & Lee, T. K. (2014). Sun-protective behaviors in populations at high risk for skin cancer. Psychology Research and Behavior Management, 7, 9-18. https://doi.org/10.2147/PRBM.S40457
  18. Fabian, E. (2022). Factors that affect access to sunscreens: A study of persons with albinism in Moshi Municipal, Tanzania. Open Journal of Social Sciences, 10, 230-251. https://doi.org/10.4236/JSS.2022.1010016
  19. Fahradyan, A., Howell, A. C., Wolfswinkel, E. M., Tsuha, M., Sheth, P. & Wong, A. K. (2017). Updates on the management of non-melanoma skin cancer (NMSC). Healthcare (Basel), 5, 82. https://doi.org/10.3390/HEALTHCARE5040082
  20. Faul, F., Erdfelder, E., Buchner, A. & Lang, A. G. (2009). Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behavior research methods, 41(4), 1149-1160.
  21. Fluehr, M., Kwok, G., Stapleton, J. L., Masterson, M. & Devine, K. A. (2023). Factors associated with sun protection behaviors among childhood cancer survivors. Journal of Pediatric Hematology/Oncology, 45, E323–E327. https://doi.org/10.1097/MPH.0000000000002618
  22. Gamage, N., Nguyen, R., Clare, I. M., Lucas, R. M., Strickland, M., Granich, J. & Gorman, S. (2021). Sun-health behaviours and attitudes towards sun safety amongst Australian teenagers: a qualitative update. BMC Research Notes. 14, 349. https://doi.org/10.1186/S13104-021-05764-9
  23. Geller, A. C., Keske, R. R., Haneuse, S., Davine, J. A., Emmons, K. M., Daniel, C. L., … Armstrong, G. T. (2019). Skin cancer early detection practices among adult survivors of childhood cancer treated with radiation. Journal of Investigative Dermatology, 139, 1898-1905.e2. https://doi.org/10.1016/J.JID.2019.02.033
  24. George, D., & Mallery, M. (2010). SPSS for Windows Step by Step: A Simple Guide and Reference, 17.0 update (10a ed.) Boston: Pearson.
  25. Glenn, B. A., Lin, T., Chang, L. C., Okada, A., Wong, W. K., Glanz, K., & Bastani, R. (2015). Sun protection practices and sun exposure among children with a parental history of melanoma. Cancer Epidemiology, Biomarkers & Prevention, 24(1), 169-177. https://doi.org/10.1158/1055-9965.EPI-14-0650
  26. Hanna, S., Marinos, E., Bryan, D., Ahmed, T., Lo, S. N., Carlino, M. S., … Saw, R. P. M. (2022). Effect of the SunSafe Student Ambassador Program on the attitudes, knowledge and behaviour of Australian high-school students towards sun safety: a prospective study. Clinical and Experimental Dermatology, 47, 1956–1967. https://doi.org/10.1111/CED.15220
  27. Haris Fadzilah, H. N. B., Yea, L. H., Hewage, M. T. J. D., Azme, F. S. M., Soe, H. H. K., Moe, S. & Htay, M. N. N. (2023). Knowledge of sunscreen usage and skin cancer among Malaysian medical students – A cross sectional study. medRxiv, https://doi.org/10.1101/2023.01.28.23285149
  28. Heckman, C. J., Manne, S. L., Kashy, D. A., Bhurosy, T., Ritterband, L. & Coups, E. J. (2021). Correlates of sun protection behaviors among melanoma survivors. BMC Public Health, 21, 882. https://doi.org/10.1186/S12889-021-10951-1
  29. Hubbard, G., Kyle, R. G., Neal, R. D., Marmara, V., Wang, Z. & Dombrowski, S. U. (2018). Promoting sunscreen use and skin self-examination to improve early detection and prevent skin cancer: quasi-experimental trial of an adolescent psycho-educational intervention. BMC Public Health, 18(1), 666. https://doi.org/10.1186/s12889-018-5570-y
  30. Khani Jeihooni, A., Bashti, S., Erfanian, B., Ostovarfar, J. & Afzali Hasirini, P. (2022). Application of protection motivation theory (PMT) on skin cancer preventive behaviors amongst primary school students in rural areas of Fasa city-Iran. BMC Cancer, 22. https://doi.org/10.1186/S12885-021-09142-3
  31. Kocak, A. N. & Adana, F. (2021). The knowledge and behavior of university students about skin cancer and sun protection: a cross-sectional research. Journal of Anatolia Nursing and Health Sciences, 24(4), 486-495. https://doi.org/10.17049/ataunihem.616340
  32. Kristjansson, S., Bränström, R., Ullen, H., & Helgason, Á. R. (2003). Transtheoretical model: investigation of adolescents’ sunbathing behaviour. European Journal of Cancer Prevention, 12(6), 501-508.
  33. Liu, X., Xu, G., Yang, W., Su, D., Yin, R., Wan, P.,. & Hong, L. (2025). Development of a transtheoretical model for the prevention and treatment of skin disease through ultraviolet protection based on 14,681 samples of outpatient clinics and a cross-sectional survey. Frontiers in Public Health, 13, 1635806. https://doi.org/10.3389/fpubh.2025.1635806
  34. Lorimer, P. D., White, R. L., Walsh, K., Han, Y., Kirks, R. C., Symanowski, J.,. & Hill, J. S. (2016). Pediatric and adolescent melanoma: a national cancer data base update. Annals of surgical oncology, 23(12), 4058-4066. https://doi.org/10.1245/s10434-016-5349-2
  35. Maddock, J. E., Rossi, J. S., Redding, C. A., Meier, K. S, Velicer, W. F & Prochaska, J. O. (1998). Development of Transtheoretical Model constructs for sun protection behaviors among adolescents. Annual Scientific Sessions of the Society of Behavioral Medicine, 20, S208, (Poster).
  36. Maleki, A., Daniali, S. S., Shahnazi, H. & Hassanzadeh, A. (2023). Application of the protection motivation theory (PMT) in teaching skin cancer prevention behaviors in male students. Journal of Cancer Education, 38, 497–504. https://doi.org/10.1007/S13187-022-02145-Z
  37. Mirzaei-Alavijeh, M., Gharibnavaz, H. & Jalilian, F. (2020). Skin cancer prevention: Psychosocial predictors of sunscreen use in university students. Journal of Cancer Education, 35, 187–192. https://doi.org/10.1007/S13187-019-01579-2
  38. Moshki, M., Karimy, M., Asl, H., Mojadam, M. & Araban, M. (2020). Predictors of sun protection behavior in high school students of Ahvaz: a cross-sectional study. International Journal of Adolescent Medicine and Health, 32(6), 20180006. https://doi.org/10.1515/ijamh-2018-0006
  39. Oğrum, A. & Demir, O. (2020). Does counseling have an effect on sun protection behaviors and early detection of skin cancer in middle-aged and older Turkish people?. TURKDERM-Turkish Archives of Dermatology and Venereology, 54(1), 9-14. https://doi.org/10.4274/turkderm.galenos.2019.25593
  40. Öncel, S. & Gündoğdu, D. (2017). The Effect on the sun protection behaviour of skin cancer risk perception: systematic review. Turkish Clin J Public Health Nurs Special Topics, 3(1), 52-60.
  41. Özdemir, İ. N., Kılınç İşleyen, E., İmren, B., Polat, Ö., & Aygün, K. (2025). The effect of sun knowledge and self-efficacy on sun protection behavior in skin cancer among young people. Journal of adolescent and young adult oncology, 14(1), 77-86. https://doi.org/10.1089/jayao.2024.0091
  42. Patel, A. R., Zaslow, T. L., Wren, T. A. L., Daoud, A. K., Campbell, K., Nagle, K. & Coel, R. A. (2019). A characterization of sun protection attitudes and behaviors among children and adolescents in the United States. Preventive Medicine Reports, 16, 100988. https://doi.org/10.1016/J.PMEDR.2019.100988
  43. Pettigrew, S., Parnell, A., Strickland, M., Neale, R. & Lucas, R. (2020). The potential of ultraviolet radiation meters in secondary schools as a sun protection intervention mechanism for adolescents. International Journal of Environmental Research and Public Health, 17, 1137. https://doi.org/10.3390/IJERPH17041137
  44. Prochaska, J. O., & Velicer, W. F. (1997). The transtheoretical model of health behavior change. American journal of health promotion, 12(1), 38-48.
  45. Republic of Türkiye Ministry of Health General Directorate of Public Health. (2022). Türkiye Cancer Statistics 2018. Ankara. Retrieved from https://hsgm.saglik.gov.tr/tr/kanser-istatistikleri. Accessed December 1, 2023
  46. Reyes-Marcelino, G., Wang, R., Gultekin, S., Humphreys, L., Smit, A. K., Sharman, A. R., … Cust, A.E. (2021). School-based interventions to improve sun-safe knowledge, attitudes and behaviors in childhood and adolescence: A systematic review. Preventive Medicine, 146, 106459. https://doi.org/10.1016/J.YPMED.2021.106459
  47. Rossi, J. S., Blais, L. M., Redding, C. A. & Weinstock, M. A. (1995). Preventing skin cancer through behavior change: implications for interventions. Dermatologic Clinics, 13, 613–622. https://doi.org/10.1016/S0733-8635(18)30067-6
  48. Rousi, E. (2022). Melanoma in children, adolescents and young adults. Doctoral dissertation, Väitöskirja. Turun yliopistonjulkaisuja – Annales Universitatis Turkuensis. Sarja – Ser. D osa –Tom. 1631. Medica Odontologica. Turku. https://urn.fi/URN:ISBN:978-951-29-8859-4
  49. Sawada, Y. & Nakamura, M. (2021). Daily lifestyle and cutaneous malignancies. International Journal of Molecular Sciences, 22, 5227. https://doi.org/10.3390/IJMS22105227
  50. Seité, S., del Marmol, V., Moyal, D. & Friedman, A. J. (2017). Public primary and secondary skin cancer prevention, perceptions and knowledge: an international cross-sectional survey. Journal of the European Academy of Dermatology and Venereology, 31, 815–820. https://doi.org/10.1111/JDV.14104
  51. Siegel, R. L., Miller, K. D., Wagle, N. S. & Jemal, A. (2023). Cancer statistics, 2023. CA: A Cancer Journal for Clinicians, 73, 17–48. https://doi.org/10.3322/CAAC.21763
  52. Sim, W. M. B., Zeng, M. X. & Rojas-Garcia, A. (2021). The effectiveness of educational programmes in promoting sun protection among children under the age of 18: A systematic review and meta-analysis. Journal of the European Academy of Dermatology and Venereology, 35, 2154–2165. https://doi.org/10.1111/JDV.17599
  53. Sümen, A. & Öncel, S. (2014). Studies conducted with students about skin cancer and sun protection: a literature review. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 7(2), 78-91.
  54. Tabachnick, B. G. & Fidell, L. S. (2014). Using multivariate statistics (New International ed.). Harlow: Pearson.
  55. Teepen, J. C., Kok, J. L., Kremer, L. C., Tissing, W. J. E., Van Den Heuvel-Eibrink, M. M., Loonen, J. J., … DCOG-LATER Study Group. (2019). Long-term risk of skin cancer among childhood cancer survivors: A DCOG-LATER cohort study. JNCI: Journal of the National Cancer Institute, 111, 845–853. https://doi.org/10.1093/JNCI/DJY212
  56. Thoonen, K., Schneider, F., Candel, M., De Vries, H. & Van Osch, L. (2019). Childhood sun safety at different ages: Relations between parental sun protection behavior towards their child and children’s own sun protection behavior. BMC Public Health, 19, 1044. https://doi.org/10.1186/S12889-019-7382-0
  57. Thorsness, S. L., Freites-Martinez, A., Marchetti, M. A., Navarrete-Dechent, C., Lacouture, M. E. & Tonorezos, E. S. (2019). Nonmelanoma skin cancer in childhood and young adult cancer survivors previously treated with radiotherapy. Journal of the National Comprehensive Cancer Network, 17, 237–243. https://doi.org/10.6004/JNCCN.2018.7096
  58. Tongco, M. D. C. (2007). Purposive sampling as a tool for informant selection. Ethnobotany Research and Applications, 5, 147–158. Retrieved from https://ethnobotanyjournal.org/index.php/era/article/view/126
  59. Trama, A., Stark, D., Bozovic-Spasojevic, I., Gaspar, N., Peccatori, F., Toss, A., … Ferrari, A. (2023). Cancer burden in adolescents and young adults in Europe. ESMO Open, 8, 100744. https://doi.org/10.1016/j.esmoop.2022.100744
  60. Tribby, C. P., Julian, A. K., Oh, A. Y. Perna, F. M. & Berrigan, D. (2020). Associations between ultraviolet radiation, tree cover and adolescent sunburns. International Journal of Health Geographics, 19, 59. https://doi.org/10.1186/s12942-020-00253-x
  61. Turcotte, L. M., Liu, Q., Yasui, Y., Henderson, T. O., Gibson, T. M., Leisenring, W., … Neglia, J.P. (2019). Chemotherapy and risk of subsequent malignant neoplasms in the childhood cancer survivor study cohort. Journal of Clinical Oncology, 37, 3310–3319. https://doi.org/10.1200/JCO.19.00129
  62. Uner, E., Kara, R., Aygun, O., & Muslu, G. K. (2023). Evaluation of sun protection behaviors of secondary school students based on transtheoretical model. International Journal of Caring Sciences, 16(3), 1394-1403.
  63. Weig, E. A., Tull, R., Chung, J., Brown-Joel, Z. O., Majee, R. & Ferguson, N. N. (2020). Assessing factors affecting sunscreen use and barriers to compliance: a cross-sectional survey-based study. Journal of Dermatological Treatment, 31, 403–405. https://doi.org/10.1080/09546634.2019.1587147
  64. World Health Organization, International Agency for Research on Cancer, Global Cancer Observatory. (2020). Cancer today; Cancer fact sheets. Retrieved from https://gco.iarc.fr/today/fact-sheets-cancers. Accessed December 1, 2023
  65. Wu, Y. P., Parsons, B. G., Aspinwall, L. G., Hay, J. L., Boucher, K. M., Caputo, H., … Leachman, S. A. (2019). Parent and child perspectives on perceived barriers to child sun protection and their association with sun protection strategies among children of melanoma survivors. Pediatric dermatology, 36, 317–323. https://doi.org/10.1111/PDE.13796
  66. You, L., Lv, Z., Li, C., Ye, W., Zhou, Y., Jin, J. & Han, Q. (2021). Worldwide cancer statistics of adolescents and young adults in 2019: A systematic analysis of the Global Burden of Disease Study 2019. ESMO open, 6(5), 100255. https://doi.org/10.1016/j.esmoop.2021.100255
  67. Liu, X., Xu, G., Yang, W., Su, D., Yin, R., Wan, P.,. & Hong, L. (2025). Development of a transtheoretical model for the prevention and treatment of skin disease through ultraviolet protection based on 14,681 samples of outpatient clinics and a cross-sectional survey. Frontiers in Public Health, 13, 1635806. https://doi.org/10.3389/fpubh.2025.1635806
  68. Lorimer, P. D., White, R. L., Walsh, K., Han, Y., Kirks, R. C., Symanowski, J.,. & Hill, J. S. (2016). Pediatric and adolescent melanoma: a national cancer data base update. Annals of surgical oncology, 23(12), 4058-4066. https://doi.org/10.1245/s10434-016-5349-2