Knowledge, attitudes and practices toward skin cancer prevention among Malaysian adults: a cross-sectional online survey.

Abstract

To assess the levels of knowledge, attitudes and practices (KAP) toward skin cancer prevention among Malaysian adults and to examine differences in KAP across socio-demographic groups. Cross-sectional online survey. Community-based study conducted in Malaysia using social media recruitment. A total of 386 adults aged ≥18 years residing in Malaysia. Most participants were young adults (86.3%), female (55.4%) and of Chinese ethnicity (65.5%). Healthcare professionals were excluded. Primary outcomes were levels of knowledge, attitude and preventive practices toward skin cancer, measured using the validated KAP-SC-Q (Knowledge, Attitude and Practice of Skin Cancer Questionnaire) and categorised as poor, moderate or good. Secondary outcomes included differences in KAP across socio-demographic and clinical characteristics, analysed using independent t-tests and χ² tests. Over half of participants demonstrated poor knowledge of skin cancer (56.0%) and the vast majority showed inadequate preventive practices (84.2%), while attitudes toward skin cancer were predominantly positive (62.4%). Significant differences in mean KAP scores and categorical levels were observed across several socio-demographic variables. Participants with tertiary education had higher knowledge (14.32 vs 12.61) and attitude scores (20.01 vs 15.95; p<0.001) than those with lower education. Individuals with a diagnosis of skin disease had significantly higher knowledge (14.95 vs 13.03; p=0.001), attitude (20.03 vs 18.21; p=0.007) and practice scores (12.10 vs 9.72; p<0.001). Personal history of skin cancer and severe sunburn was associated with better preventive practices but poorer attitudes (p<0.001), and light-skinned participants were more likely to have poor knowledge and attitudes (p<0.05). Malaysian adults exhibited limited knowledge and very poor preventive practices toward skin cancer despite generally positive attitudes. These findings highlight substantial gaps between awareness and behaviour and support the need for targeted public health interventions to correct misconceptions, improve risk perception especially in high-risk groups and promote effective ultraviolet protection behaviours.