Do Australians know more about melanoma than Scots? A questionnaire study

BACKGROUND Malignant melanoma incidence is increasing in all Caucasian populations. Incidence is highest in Australia where it has increased by 85% in men and 31% in women between 1983 and 2001. Scotland has fewer cases but, alarmingly, a relatively greater increase in incidence, 283% in men and 236% in women between 1985 and 2007. Little is known about the extent to which Scottish people have learned about melanoma and risk reducing behaviour compared to Australians, where public health efforts are long-standing and well resourced. AIM To compare personal risk; level of concern; knowledge and self-reported protective behaviour between the Scottish and Australian populations. METHOD A validated questionnaire was administered in Western Australia and Grampian. Questionnaires were coded and scored. Demographics were described and compared. Four summary scores were generated (personal risk score; level of concern score; melanoma knowledge score; protective behaviour score) by summing responses to questionnaire items. Median scores were analysed using the Mann-Whitney U test. Binary logistic regression was used to adjust for potential confounders and identify independent predictors of good performance. RESULTS 271 Scots and 265 Australians responded. Personal risk of melanoma was similar between Australians and Scots (mean 11.6 vs mean 11.4, p<0.517). Australians were more concerned about melanoma (5.5 vs 3.1, p<0.005), practiced more sun protection (13.6 vs 11.9, p<0.005), and knew more about melanoma (13.9 vs 11.9). Following adjustment for potential confounders, Australian nationality remained predictive of a high concern, practicing sun protection and melanoma knowledge. Younger age, high educational attaintment, personal history of skin cancer, and knowing someone with skin cancer were independently predictive of high concern, practicing sun protection and melanoma knowledge. CONCLUSIONS Australian people are better prepared to protect themselves against skin cancer than Scots. This behoves Scottish health policy makers to study and implement the Australian model here.