Microbial diversity in the deep sea and the underexplored “rare biosphere”

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Abstract
Background In the light of increasing skin cancer incidences worldwide, preventive measures to promote sun protection in individuals with risky sun habits have continued relevance and importance. Aim To report the long-term effect of individualised sun protection advice given in primary health care (PHC), on sun habits and sun protection behaviour. Design & setting In 2005, 309 PHC patients were enrolled in a randomised controlled study performed in a Swedish PHC setting. Method At baseline, the study participants completed a Likert scale-based questionnaire, mapping sun habits, propensity to increase sun protection, and attitudes towards sun exposure, followed by randomisation into three intervention groups, all receiving individualised sun protection advice: in Group 1 (n = 116) by means of a letter, and in Group 2 (n = 97) and 3 (n = 96) communicated personally by a GP. In Group 3, participants also underwent a skin ultraviolet-sensitivity phototest, with adjusted sun protection advice based on the result. A repeated questionnaire was administered after 3 and 10 years. Results Statistically significant declines were observed in all groups for sun exposure mean scores over time. When using a cumulative score, according to the Sun Exposure and Protection Index (SEPI), significantly greater decrease in SEPI mean score was observed in Groups 2 and 3 (GP), compared to Group 1 (letter); P<0.01. The addition of a phototest did not enhance the effect of the intervention. Conclusion Individualised sun protection advice mediated verbally by the GP can lead to sustained improvement of sun protective behaviour.