Skin Cancer: Mass Media

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Findings and Recommendations

The Community Preventive Services Task Force (CPSTF) finds insufficient evidence to determine effectiveness of mass media interventions to prevent skin cancer by reducing exposure to ultraviolet radiation. Although available evidence generally indicates that mass media interventions are associated with improvements in protective and preventive behaviors, the small number of studies, several with methodological limitations, make it difficult to draw clear conclusions.

The full CPSTF Finding and Rationale Statement and supporting documents for Preventing Skin Cancer: Mass Media are available in The Community Guide Collection on CDC Stacks.

Intervention

Mass media interventions to prevent skin cancer by reducing individuals’ exposure to ultraviolet (UV) radiation use communication channels such as print media (e.g., newspapers, magazines), broadcast media (e.g., radio, television), billboards, or the Internet to disseminate information, behavioral guidance, or a combination of these to wide audiences. Messages may target specific audiences, although the interventions typically rely on broad distribution channels. Some interventions provide up-to-date information about the intensity of the sun’s rays (UV index), with the goal of raising awareness of the dangers of UV exposure and prompting sun protection measures. Others use persuasive techniques intended to change knowledge, attitudes, beliefs, intentions, and behaviors related to sun-protection and skin cancer.

Although this review assessed the effectiveness of mass media interventions themselves, eligible interventions could also use small media (e.g., brochures, flyers, newsletters) or promotional products to increase awareness of campaign messages.

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of 4 studies (search period January 1966–May 2011). The review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to preventing skin cancer. This finding updates and replaces the 2003 CPSTF finding on Mass Media Campaigns.

Study Characteristics

  • Studies were conducted in Australia (2 studies), the United States (1 study), and Denmark (1 study)
  • The studies included in this review evaluated mass media interventions that delivered persuasive massages over varying time periods to influence attitudes and behaviors
  • Two of the included studies evaluated the effectiveness of mass media interventions when implemented alone, and two evaluated mass media interventions used in combination with small media (e.g., brochures)

Summary of Results

  • Sun protective behaviors (3 studies): Interventions led to overall increases in sun protective behaviors (e.g., use of sunscreen, protective clothing, hats, and shade) among adults and children
  • Risk behaviors (2 studies)
    • One study showed that increased exposure to televised messages about sun protection (1987-2002) was associated with a decrease in amount of exposed skin on the average person’s body (−2.0% decrease per 100 target audience rating points [TARP] increase in advertising intensity)
    • Another study showed an anti-sunbed campaign resulted in decreased use of tanning beds: Overall incidence of tanning bed use (odds ratio [OR]=0.61; 95% confidence interval [CI]: 0.54, 0.69); proportion of children (<13 years) who had ever used tanning beds (−5 percentage points, p< 0.001); proportion of teens (13-15 years) who used tanning beds (−10 percentage points, p<0.001)

Summary of Economic Evidence

An economic review of this intervention was not conducted because CPSTF did not have enough information to determine if the intervention works.

Applicability

Applicability of this intervention across different settings and populations was not assessed because CPSTF did not have enough information to determine if the intervention works.

Evidence Gaps

  • High-quality studies are needed on the effectiveness of mass media interventions to reduce UV exposure, including:
    • Studies with unexposed comparison communities
    • Studies assessing the varying effects of intervention intensity
    • Interrupted time series studies
  • More evidence is needed to determine variability in the effectiveness of interventions by type of message (e.g., information only versus persuasive messages), or types of channel used (e.g., internet, newspaper).
  • More research is needed to examine interventions that use social media to disseminate messages.

Implementation Considerations and Resources

CPSTF did not have enough evidence to determine whether the intervention is or is not effective. This does not mean that the intervention does not work, but rather that additional research is needed to determine whether or not the intervention is effective.