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Impact of Skin Cancer Awareness Education on Skin Cancer Warning-Sign Recognition among Adults in Nigeria

Abstract

Skin cancer is an important public health concern because delayed recognition of suspicious skin changes may contribute to late presentation, delayed diagnosis, and poorer treatment outcomes. Although skin cancer may be less commonly recognized in some African populations, adults in Nigeria may still be exposed to relevant risk factors, including ultraviolet radiation, occupational outdoor exposure, prolonged sun exposure, certain skin conditions, and other individual risk factors. Limited awareness of skin cancer warning signs may make it difficult for individuals to recognize suspicious lesions or know when professional assessment is necessary. Skin cancer awareness education provides an opportunity to improve knowledge of warning signs, risk factors, sun-protection practices, skin self-observation, and appropriate healthcare-seeking. Against this background, this study investigates the impact of skin cancer awareness education on skin cancer warning-sign recognition among adults in Nigeria. The study will be anchored on the Health Belief Model, Health Literacy Framework, and Social Cognitive Theory. The Health Belief Model explains how adults' perceptions of susceptibility to skin cancer, perceived severity, perceived benefits of early recognition, perceived barriers, and cues to action may influence their ability to recognize suspicious skin changes and seek appropriate care. The Health Literacy Framework emphasizes the ability to access, understand, evaluate, and apply health information concerning skin cancer and its warning signs. Social Cognitive Theory emphasizes observational learning, self-efficacy, social influence, reinforcement, and environmental factors in developing appropriate skin-health behaviours. Collectively, these theoretical perspectives provide a suitable framework for explaining how skin cancer awareness education may influence skin cancer warning-sign recognition among adults in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise adults aged 18 years and above residing in selected urban, semi-urban, and rural communities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, households, and eligible adults. Skin cancer awareness education will be assessed using indicators such as exposure to educational sessions, frequency and duration of education, information on skin cancer risk factors, ultraviolet radiation, occupational sun exposure, sun-protection measures, suspicious skin changes, warning signs, skin self-observation, appropriate healthcare-seeking, and available diagnostic and treatment services. Skin cancer warning-sign recognition will be assessed using indicators such as the ability to identify persistent or changing skin lesions, changes in lesion size, shape, or colour, irregular borders, non-healing sores, persistent bleeding or crusting, new suspicious growths, changes in existing moles or pigmented lesions, and recognition of skin changes requiring professional evaluation. Scenario-based or image-assisted assessment may be used where appropriate to evaluate participants' ability to recognize suspicious skin lesions. Data will be collected using structured questionnaires, standardized skin-cancer knowledge assessment tools, validated image-based recognition tasks where available, and relevant community health education records. Descriptive statistics will be used to summarize participants' characteristics, skin-cancer knowledge, exposure to awareness education, sun-exposure patterns, and warning-sign recognition. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of skin cancer awareness education on warning-sign recognition. Where a quasi-experimental design is adopted, recognition scores before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that skin cancer awareness education has a significant positive impact on skin cancer warning-sign recognition among adults in Nigeria. Adults exposed to structured and practical skin cancer education are expected to demonstrate greater ability to recognize suspicious skin changes than adults without comparable exposure. Education may improve understanding of common skin cancer warning signs and help participants distinguish potentially concerning lesions from ordinary skin changes. Image-based and practical education may strengthen recognition of changes in colour, size, shape, borders, bleeding, crusting, and persistent non-healing lesions. Increased awareness may also encourage adults to monitor suspicious changes and seek appropriate medical assessment rather than relying on self-treatment or delaying care. However, limited awareness of skin cancer among the general population, misconceptions regarding susceptibility, cultural perceptions of skin conditions, limited access to dermatological services, financial barriers, and low availability of specialist care may reduce the effectiveness of education alone. The study therefore expects accessible, culturally appropriate, evidence-based, and practical skin cancer awareness education, supported by accessible healthcare and referral services, to contribute significantly to improved warning-sign recognition among adults in Nigeria. The study is expected to contribute to the literature on skin cancer awareness, skin cancer prevention, cancer health education, early cancer detection, dermatological health, sun protection, health literacy, adult health, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, teaching hospitals, primary healthcare centres, dermatologists, oncologists, healthcare professionals, public health practitioners, community health workers, cancer-control organizations, development partners, and policymakers regarding strategies for improving early recognition of skin cancer. The study will also provide evidence-based recommendations for integrating skin cancer awareness into community health programmes, strengthening public education on skin cancer warning signs, promoting appropriate sun-protection practices, improving healthcare workers' capacity for early recognition and referral, increasing public awareness of available diagnostic services, and encouraging timely medical evaluation of suspicious skin changes across Nigeria.

Keywords: Skin cancer awareness education, skin cancer warning-sign recognition, skin cancer, early detection, skin health, cancer prevention, health education, health literacy, adults, Nigeria, public health.