A review of skin cancer primary prevention activities in primary care settings

Nehal Singh; Kate LA Dunlop; Nikki Woolley; Tracey Wills Vashishtha; Diona L Damian; Kylie Vuong; Anne E Cust; Amelia K Smit

doi:10.17061/phrp34012401

A review of skin cancer primary prevention activities in primary care settings

Public Health Res Pract. 2024 Feb 6:34012401. doi: 10.17061/phrp34012401. Online ahead of print.

Authors

Nehal Singh¹, Kate LA Dunlop², Nikki Woolley³, Tracey Wills Vashishtha³, Diona L Damian⁴, Kylie Vuong⁵, Anne E Cust⁶, Amelia K Smit⁷

Affiliations

¹ The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Australia.
² The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Australia; Melanoma Institute Australia, University of Sydney, NSW, Australia.
³ Cancer Institute NSW, Sydney, Australia.
⁴ Melanoma Institute Australia, University of Sydney, NSW, Australia ; Royal Prince Alfred Hospital, Sydney, NSW, Australia; Dermatology, Central Clinical School, Faculty of Medicine and Health, University of Sydney, NSW, Australia.
⁵ School of Medicine and Dentistry, Griffith University, Southport, Queensland, Australia ; School of Population Health, UNSW Sydney, Australia.
⁶ The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Australia; Melanoma Institute Australia, University of Sydney, NSW, Australia ; Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, NSW, Australia.
⁷ The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Australia; Melanoma Institute Australia, University of Sydney, NSW, Australia ; Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, NSW, Australia; amelia.smit@sydney.edu.au.

PMID: 38316050
DOI: 10.17061/phrp34012401

Abstract

Objectives: Skin cancer is highly preventable through primary prevention activities such as avoiding ultraviolet radiation exposure during peak times and regular use of sun protection. General practitioners (GPs) and primary care nurses have key responsibilities in promoting sustained primary prevention behaviour. We aimed to review the evidence on skin cancer primary prevention activities in primary care settings, including evidence on feasibility, effectiveness, barriers and enablers.

Study type: Rapid review and narrative synthesis.

Methods: We searched published literature from January 2011 to October 2022 in Embase, Medline, PsychInfo, Scopus, Cochrane Central and CINAHL. The search was limited to skin cancer primary prevention activities within primary care settings, for studies or programs conducted in Australia or countries with comparable health systems. Analysis of barriers and enablers was informed by an implementation science framework.

Results: A total of 31 peer-reviewed journal articles were included in the review. We identified four main primary prevention activities: education and training programs for GPs; behavioural counselling on prevention; the use of novel risk assessment tools and provision of risk-tailored prevention strategies; and new technologies to support early detection that have accompanying primary prevention advice. Enablers to delivering skin cancer primary prevention in primary care included pairing preventive activities with early detection activities, and access to patient resources and programs that fit with existing workflows and systems. Barriers included unclear requirements for skin cancer prevention counselling, competing demands within the consultation and limited access to primary care services, especially in regional and remote areas.

Conclusions: These findings highlight potential opportunities for improving skin cancer prevention activities in primary care. Ensuring ease of program delivery, integration with early detection and availability of resources such as risk assessment tools are enablers to encourage and increase uptake of primary prevention behaviours in primary care, for both practitioners and patients.