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 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.
Methods: We searched published literature from January 2011 to October 2022 in Embase, Medline, PsychInfo, Scopus, Cochrane Central and CINAHL, and relevant grey literature sources such as cancer and skin cancer peak bodies and general practice organisations. 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.
Results: A total of 34 peer-reviewed journal articles and 26 grey literature resources were included in the review. We identified four main primary prevention activities: behavioural counselling; risk assessment and delivering risk-tailored information; new technologies for early detection with linked primary prevention information; and education and training programs for the primary care workforce. Enablers to delivering skin cancer primary prevention in primary care included its pairing with early detection activities, and access to patient resources and programs which 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 enhancing skin cancer prevention activities in primary care. 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.