Questions Primary prevention

Is there evidence that wearing clothes and hats or that the use of shade reduces the risk of skin cancers?

Few RCTs were found. Those that were found had already been included in an unpublished review of 11 intervention studies, which also included randomised pretest and post-test studies. This review suggested that, where effective interventions have been identified, little work has been undertaken to identify the most effective strategies for disseminating interventions, particularly in schools, the community and workplaces. The analysis indicated a low prevalence of sun-protection behaviours, particularly for the use of hats (randomised observational study) and protective clothing, although the use of shade was increasing in a number of target groups. In a randomised observation study of beach behaviour in Australia, 17% used hats, 15% used shade, and recommended shorts and shirts were used by 15%. Outdoor market traders did not use such clothing.15-18

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