Perceptions about skin cancer and photoprotection among Medical students on the Piauí coast

ABSTRACT

Introduction:  Skin cancer is the most prevalent malignancy in Brazil, particularly non-melanoma types, which have a high cure rate when detected early. Ultraviolet (UV) radiation is the main risk factor, inducing burns, photoaging, and mutations that may lead to neoplasms. Photoprotection, through sunscreen use, appropriate clothing, and preventive behaviors, is crucial to reduce risk, especially in regions with high sun exposure, such as Northeastern Brazil.

Objective:  To assess medical students’ knowledge, attitudes, and practices regarding skin cancer and photoprotection, identifying gaps in malignant lesion recognition, correct sunscreen application, and awareness of artificial tanning risks, with the goal of informing educational strategies to enhance dermatological prevention and care.

Methods:   This cross-sectional, observational study evaluated 105 medical students from two institutions in Parnaíba, Piauí, between March 2024 and July 2025. Data were collected via a structured online questionnaire covering sociodemographic characteristics, theoretical knowledge, preventive practices, risk perception, and ability to identify malignant lesions using the ABCDE criteria. The study was approved by the Ethics Committee, CAAE: 77412724800000014.

Results:  Academic courses were the primary source of information on skin cancer, followed by scientific literature and awareness campaigns. While students recognized the importance of dermatological examinations and preventive measures, most demonstrated only partial ability to distinguish melanoma from other malignant lesions and to apply sunscreen correctly. Regarding artificial tanning, students were aware of the associated risks and largely supported prohibiting tanning beds, although more than half had not received detailed information on their harmful effects. Preventive behaviors differed significantly by sex, with women reporting more frequent sunscreen use.

Conclusions:  Although theoretical knowledge among medical students is adequate, practical skills and risk awareness require reinforcement. Targeted educational interventions are needed to prepare future physicians to reduce skin cancer incidence in regions with high UV exposure.

Keywords:
Skin Neoplasms; Sunscreening Agents; Medical Students. Tanning Chambers. Health Education

RESUMO

Introdução:  O câncer de pele é a neoplasia mais comum no Brasil, especialmente o tipo não melanoma, com alta cura se detectado precocemente. A radiação ultravioleta é o principal fator de risco, causando queimaduras, fotoenvelhecimento e mutações que podem levar a neoplasias. A fotoproteção, por meio de proteção solar, roupas adequadas e comportamentos preventivos, é essencial para reduzir o risco, sobretudo em regiões com intensa exposição solar, como o Nordeste brasileiro.

Objetivo:  Este estudo teve como objetivos avaliar o conhecimento, as atitudes e as práticas de estudantes de Medicina em relação ao câncer de pele e à fotoproteção, e identificar lacunas no reconhecimento de lesões malignas, no uso correto do protetor solar e na percepção de riscos associados ao bronzeamento artificial, visando subsidiar estratégias educativas potencializadoras da prevenção e do cuidado dermatológico.

Método:  Este estudo observacional, transversal e quantitativo avaliou 105 estudantes de Medicina em duas instituições de Parnaíba, no Piauí, no período de março de 2024 a julho de 2025, objetivando identificar conhecimentos, atitudes e práticas relacionados ao câncer de pele e à fotoproteção. A coleta de dados foi realizada por questionário online estruturado que abordou variáveis sociodemográficas, conhecimento teórico, práticas preventivas, percepção de riscos e habilidade em reconhecer lesões malignas mediante a ferramenta ABCDE. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa sob o CAAE nº 77412724800000014.

Resultado:  Segundo relatos, a principal fonte de informação sobre câncer de pele foram as aulas acadêmicas, seguidas por literatura científica e campanhas de conscientização. Embora reconheça a importância de exames dermatológicos e da prevenção, a maioria apresentou habilidade apenas parcial em diferenciar melanoma de outras lesões malignas e em aplicar corretamente o protetor solar. Quanto ao bronzeamento artificial, houve consciência sobre os riscos e forte apoio à proibição de câmaras de bronzeamento, embora mais da metade não tivesse recebido informações detalhadas sobre seus efeitos nocivos. Observou-se ainda diferença significativa de comportamento preventivo entre sexos, sendo o uso de protetor solar mais frequente entre mulheres.

Conclusão:  Apesar do bom conhecimento teórico, é necessário fortalecer habilidades práticas e orientação sobre riscos, visando preparar os futuros médicos para a redução da incidência de câncer de pele em regiões de alta exposição solar.

Palavras-chave:
Neoplasias Cutâneas; Protetores Solares; Estudantes de Medicina; Câmaras de Bronzeamento; Educação em Saúde

INTRODUCTION

The skin is the main interface between the body and the environment, being regularly exposed to various environmental aggressions, including solar radiation and pollutants, making it the first defense system against the external environment¹. Solar radiation contains ultraviolet (UV) radiation in the range of 100 to 400 nm. The UV radiation that reaches Earth is a combination of UVB (280 to 315 nm) and UVA (315 to 400 nm), while UVC (100 to 280 nm) is blocked by the ozone layer. Acute effects of UV radiation on the skin include erythema, sunburn, and photoimmunosuppression. In the short term, UVB exposure is responsible for sunburns and direct DNA damage². UVA radiation is more constant during the day and contributes to skin photoaging, in addition to causing mutations and neoplasms due to the formation of free radicals, reactive oxygen species (ROS) and long-lasting hyperpigmentation. Other radiations are also capable of producing these effects, such as visible light and infrared radiation, generating phototoxicity and post-inflammatory hyperpigmentation³.

To reduce the adverse effects of solar radiation, the use of sunscreens is recommended, which consist of cosmetic preparations applied to the skin composed of substances that absorb, disperse, or reflect UV radiation⁴. The efficacy and accuracy of sunscreens can be quantified through the sun protection factor (SPF), which is determined through an in vivo measurement, and the value is obtained by the ratio between the minimum erythematous dose (MED) in skin protected by a sunscreen and MED in unprotected skin. It is important to emphasize that the degree of SPF is counterintuitive and does not consist of a linear measure, since an SPF 15 absorbs 93.3% of the radiation that induces erythema, an SPF 30 absorbs 96.7%, and an SPF 50 absorbs about 98% of the UVB radiation, so an SPF 30 is not twice as powerful as an SPF 15⁵.

Skin cancer is the most prevalent neoplasm in Brazil and worldwide, corresponding to approximately 33% of all diagnoses of malignant tumors in the country⁶. Non-melanoma skin cancer is the most frequent type in the Brazilian population, with a high percentage of cure if diagnosed early. Its most common tumors are basal cell carcinoma (BCC), which is the most common and least aggressive (about 70% of non-melanoma cases), and squamous cell carcinoma (SCC) (about 25% of non-melanoma cases). Melanoma, which originates in melanin-producing cells, is the skin cancer with the worst prognosis and highest mortality, affecting more fair-skinned people⁷.

In Brazil, photoprotection recommendations based on studies from the USA and Europe are not always adequate, as the country has UV radiation levels among the highest in the world, especially under clear skies. In the Northeast, where the semi-arid climate predominates, intense sun exposure throughout the year favors the development of skin cancer, especially among rural workers and young people influenced by aesthetic standards. Although 98% of the population recognizes the risks of exposure to the sun, about 63% still expose themselves without protection. In 2020, 52,527 cases of malignant melanoma and other neoplasms were recorded, and between 2013 and 2021 the Northeast accounted for 29,236 cases, with emphasis on the states of Bahia and Ceará⁸.

For the year 2026, data from the National Cancer Institute (INCA) outline a scenario of attention on the incidence of skin cancer in the Northeast. The region should consolidate itself as the third in Brazil with the highest number of cases, behind only the Southeast and South. Throughout the northeastern territory, the estimate points to a significant volume of 40,150 new diagnoses of non-melanoma tumors, a number vastly higher than the 1,410 cases projected for the melanoma variation⁹.

When looking at the distribution of these numbers, we notice that the incidence of the disease varies greatly between states. Bahia and Ceará, for example, emerge with the highest projections in the region in a very isolated way, with Bahia leading the estimates with 11,430 expected cases of non-melanoma cancer and 320 of melanoma. Ceará comes next, with the expectation of 11,110 diagnoses of the non-melanoma variation and 300 of melanoma. Pernambuco, on the other hand, appears at a next level, projecting 4,460 new cases of the non-melanoma type and 230 of melanoma⁹.

There is also a group of states with intermediate incidences and numbers very close to each other. Rio Grande do Norte has 3,830 non-melanoma cases and 140 melanoma cases expected; Piauí expects 3,690 and 80; Paraíba projects 3,590 and 120; and Maranhão estimates 3,380 non-melanoma occurrences associated with 100 cases of melanoma⁹.

Finally, the lowest absolute volumes of new cases in the region are concentrated in Sergipe and Alagoas. While Sergipe expects 2,610 diagnoses of the non-melanoma form of the disease, Alagoas follows the same trend of lower incidence, estimating 2,450 cases. A curious fact is that both states share exactly the same projection for melanoma, with 60 occurrences expected in each for 2026⁹.

In this sense, it is a public health problem, subject to prevention and early diagnosis, so health students, particularly medical students, should be proactive agents in promoting information and prevention of this type of neoplasm. Therefore, it is extremely important to encourage the knowledge of these future professionals about photoprotection, both to encourage self-care and to disseminate accurate information to the population.

However, studies have revealed gaps in the knowledge and practice of photoprotection among medical students, since some precepts of good sun protection practices are not yet fully known and the students who do know it still perform it in inadequate ways in relation to what is recommended by dermatology societies. For example, in a study in Salvador/BA, only 35% of students said they used sunscreen daily, but almost 40% never reapplied it. In addition, some showed a preference for sun exposure at times of high risk and did not adhere to complementary methods of sun protection such as caps and long-sleeved clothing. In addition, the high prevalence of sunburn in these students was also a factor of concern¹⁰.

Considering the high incidence of skin cancer in Brazil, the intense sun exposure characteristic of the Northeast region, and the strategic role of future physicians in health promotion, it is essential to understand the level of knowledge and preventive practices related to photoprotection among medical students. Previous studies indicate relevant gaps in this population, especially regarding the correct application of sunscreen, recognition of suspicious lesions, and preventive approach in a clinical context. Thus, the present study aimed to evaluate the knowledge, attitudes and practices related to the diagnostic aspects of skin cancer and photoprotection in the context of medical education, identifying implications for teaching and future clinical practice.

METHOD

Study design and context

This is an observational study, with a quantitative approach, with a descriptive and cross-sectional design. The research was carried out in two Higher Education Institutions (HEIs) in Parnaíba, Piauí, with data collected from March 2024 to July 2025. The main objective was to evaluate medical students’ knowledge and attitudes about skin cancer.

Participants and eligibility

The target population consisted of students regularly enrolled in the medical course of the two institutions located in the studied city. The sample was defined by convenience and totaled 105 participants, considering the availability of students during the collection period, with no previous sample size calculation. This strategy was adopted due to the exploratory nature of the study.

Students from all periods who confirmed their institutional affiliation were included when they continued to fill out the form, since the exclusivity of that form for medical students was highlighted on the home page. On the other hand, refusal to accept the Informed Consent Form (ICF) or incomplete filling out of the form were established as exclusion criteria (although all 105 completed the instrument).

Variables and data sources

Variables of interest included:

• Predictors/Confounders: Sociodemographic data.

• Outcomes: Theoretical knowledge, preventive practices, perception of risk factors, and clinical attitudes.

Data collection and variables

Data collection took place via the Google Forms platform, using a structured questionnaire with 30 multiple-choice questions. The questionnaire used was prepared by the researchers based on instruments previously used in similar studies on photoprotection and skin cancer, being submitted to an evaluation of clarity and relevance by experts in the field and to a pre-test with students who were not part of the final sample, with the objective of adjusting language and understanding of the questions.

The instrument addressed sociodemographic variables, theoretical knowledge about skin cancer, preventive practices, perception of risk factors and attitudes towards prevention and patient guidance. These variables were defined as outcomes and predictors for data analysis. The form was disseminated virtually through social networks and student groups, and participation was voluntary, anonymous and without any type of personal identification, ensuring the secrecy and confidentiality of the information provided. Only students who confirmed that they were enrolled in the medical course at institutions based in Parnaíba-PI were included in the research. All participants met the inclusion criteria and completed the questionnaire.

Statistical Analysis

Quantitative data were analyzed using descriptive statistics (absolute and relative frequencies) and inferential statistics, with interpretation of the results in the light of the literature. Pearson’s chi-square test was used to assess the existence of statistically significant associations between categorical variables. All statistical analyses were processed using the BioStat® software, adopting a significance level of p < 0.05. In addition, a critical and interpretative reading of the data was carried out, seeking to understand the meanings and nuances in the students’ perceptions about safety in the use of sunscreens and the influence of the media on aesthetic standards.

This study was previously submitted to and approved by the Research Ethics Committee (REC) (CAAE: 77412724.8.0000.0014), in accordance with the ethical principles established by Resolution N. 466/2012 of the National Health Council. All participants were informed about the research objectives and consented to their participation in a free and informed manner.

RESULTS

Medical Students’ Perceptions and Knowledge of Skin Cancer and Sun Protection

This study is a comprehensive research, which included 105 medical students from two institutions located in Parnaíba-PI. The investigation revealed important insights into the knowledge and perceptions of these future health professionals regarding skin cancer, protection methods, and the risks of indoor tanning. All participants were medical students at one of the two institutions.

Participants’ Demographic Characteristics

The sample was predominantly female, with 67 (63.8%) participants, compared with 38 (36.2%) males. There were no responses to the options “Other” or “I prefer not to say”. The distribution of students by semester showed a greater concentration in the final periods of the course, with 36 (34.3%) in the 9^th semester, and 12 (11.4%) in both the 7^th and 11^th semesters of clinical training. The representation of the other periods was as follows: 10^th semester with 11 (10.5%); 6^th with 8 (7.6%); 8^th with 7 (6.7%); 4^th and 12^th with 6 (5.7%) each; 1^st, 3^rd and 5^th with 2 (1.9%) each; and the 2^nd semester with 1 (1.0%) student.

Knowledge and Perception about Skin Cancer

Academic classes were the main source of information about skin cancer for 42 (40%) of the students, followed by reading books and scientific articles (28.6%) and media awareness campaigns (19%). In addition, in terms of adherence to sun protection, there was no statistically significant association in relation to the semesters, since the students in the initial semesters reported using sunscreen daily in a proportion similar to the final semesters, as shown in Table 1.

Table 1
Association between Semester and Use of Sunscreen in Medical Students, Parnaíba-PI, 2024.

Semesters	Daily n(%)	Sometimes n (%)	Rarely n (%)	Never n (%)	Chi-square (χ²)	df	p-value
Initial	50%	3.8%	23.1%	3.8%	7.66	6	0.264
Intermediary	32.2%	16.9%	35.6%	8.5%
Final	53.1%	9.4%	21.9%	6.3%

• Legend: df = degrees of freedom; p < 0.05 indicates a statistically significant association (in bold). Initial: 1^st to 6^th semesters; Intermediary: 7^th to 9^th semesters; Final: 10^th to 12^th semesters. Source: research data.

Regarding personal and professional experience, the majority of students, 53 (50.5%), did not have cases of skin cancer among family members or acquaintances, while 43 (41%) stated that they had had one. In the clinical context, 50 (47.6%) had seen patients with skin cancer more than once during the internships, and 22 (21%) had seen only once, with a relevant frequency of contact with skin cancer cases during the practical training, as shown in Table 2.

Table 2
Association between the academic semester and observing skin neoplasms in internships.

Semesters	Never	Once	> once	Chi-square (χ²)	df	p-value
Initial	59.3%	14.8%	3.7%	36.05	4	0.001
Intermediary	22%	27.1%	44.1%
Final	12.5%	6.3%	71.9%

• Legend: df = degrees of freedom; p < 0.05 indicates a statistically significant association (in bold). Source: research data.

The ability to recognize and differentiate malignant lesions presented challenges. The majority, 53 (50.5%), stated that they were able to differentiate melanoma from other forms of skin cancer only partially. Only 17 (16.2%) said they were sure. Similarly, 41 (39%) considered themselves partially able to recognize potential malignant lesions using the ABCDE tool (Table 3).

Table 3
Association between Semester and Aptitude in the Use of the ABCDE Tool.

Semesters	Absolutely	Partially	Not able	Cannot Affirm	Chi-square (χ²)	df	p-value
Initial	21.2%	9.1%	24.2%	9.1%	17.23	6	0.008
Intermediary	21.8%	50.9%	14.5%	12.7%
Final	37.8%	27%	5.4%	8.1%

• Legend: df = degrees of freedom; p < 0.05 indicates a statistically significant association (in bold). Source: research data.

The importance of prevention and awareness was widely recognized. The vast majority, 79 (75.2%), considered regular dermatological examinations to be essential. Almost all of them, 103 (98.1%), considered it important to raise awareness of specific risk groups, such as outdoor workers. However, more than half of the students, 59 (56.2%), feel only partially sure in addressing issues related to skin cancer during medical consultations (Table 4).

Table 4
Association between the Academic Semester and assurance in Addressing skin care.

Semesters	Totally sure	Partially sure	Little unsure	Chi-square (χ²)	df	p-value
Initial	39.3%	17.9%	17.9%	11.43	4	0.022
Intermediary	25.4%	59.4%	8.5%
Final	21.9%	59.4%	9.4%

• Legend: df= degrees of freedom; p < 0.05 indicates a statistically significant association (in bold). Source: research data.

Perception of Indoor Tanning and Beauty Standards

The research revealed a strong awareness of the media influence. A vast majority, 95 (90.5%), agree that the media has a significant role in promoting beauty standards, encouraging practices that are harmful to skin health, such as excessive tanning. In addition, 76 (72.4%) do not consider self-medication with tanning creams or lotions safe.

The use of tanning beds was widely associated with risks: the majority of students believe that frequent use substantially (61.9%) or moderately (31.4%) increases the risk of skin cancer. There was strong support for banning these chambers as a preventative measure, with 41% strongly agreeing and 40% partially agreeing. However, the perception of the effectiveness of this ban in reducing cases of skin cancer was more divided, with 53 (50.5%) believing that it would be moderately effective and 24 (22.9%) not believing that it would be effective.

When approaching patients who express a desire for an artificial tan, the vast majority, 70 (66.7%), would inform about the health risks. A significant part of the students, 72 (68.6%), believe that awareness should be more emphasized in relation to individual freedom of aesthetic choice. A fact of concern is that more than half, 56 (53.3%), did not have access to specific information about the risks associated with artificial tanning during their academic training. In addition, 53 (50.5%) of the students did not notice changes in patient awareness of the risks of indoor tanning in recent years (Table 5).

Table 5
Association between the Semesters and Access to information on the Risks of Tanning.

Semesters	None	Superficial	Detailed	I don’t know	Chi-square (χ²)	df	p-value
Initial	48.1%	29.6%	17.6%	17.6%	12.63	6	0.049
Intermediary	54.2%	39%	0%	10.2%
Final	34.4%	43.8%	9.4%	3.1%

• Legend: df = degrees of freedom; p < 0.05 indicates a statistically significant association (in bold). Source: research data.

Knowledge and Practice about Sunscreen

Regarding the use of sunscreen, 49 (46.7%) reported using it daily as a routine, and 52 (49.5%) used it daily as part of their regular routine, while 18 (17.1%) used it only in the pool or beach and 19 (18.1%) rarely used it. Regarding sex, women demonstrate an excellent preventive habit: the vast majority have already incorporated the product into their daily routine (62.69%) and none of them stops using it completely. On the other hand, the male scenario serves as a warning, since daily care among them is three times lower (18.42%). Most men end up neglecting their skin health, choosing to use sunscreen only rarely (50%) or, in more worrying cases, confirming that they never use it (21.05%).

The majority, 77 (73.3%), know that “SPF” stands for Sun Protection Factor and indicates the ability to block ultraviolet rays. However, a knowledge gap was identified in understanding the difference between SPF 30 and SPF 50: 54 (51.4%) mistakenly believe that SPF 50 offers twice the protection of SPF 30, with only 31 (29.5%) believing that there is no significant difference, which is closer to reality.

Regarding the time of application, the majority, 68 (64.8%), know that sunscreen should be applied 15 to 30 minutes before exposure to the sun. The majority, 63 (60%), consider that all factors (water resistance, texture and aroma, product color) should be considered when choosing sunscreen, but water resistance was the most chosen factor individually (37.1%). Only 37 (35.2%) know the recommended amount of sunscreen to be applied to each part of the body.

The vast majority, 79 (75.2%), are aware that the amount of sunscreen applied directly influences the product effectiveness. When approaching a patient who uses an inadequate sunscreen, the majority, 66 (62.9%), would inform about the importance of adequate SPF. The vast majority, 86 (81.9%), consider water resistance a crucial factor in sunscreen effectiveness.

Improving awareness of the proper use of sunscreen, according to students, can be achieved through educational campaigns, integrating information into routine exams, and providing informational material, with 56 (53.3%) believing that all options are valid.

DISCUSSION

The results of the research demonstrate that medical students in Parnaíba-PI have a solid base of knowledge about skin cancer, mainly acquired through the academic curriculum. The prevalence of students from more advanced semesters in the research suggests that exposure to clinical disciplines and internships may be contributing to this base. The predominance of academic classes as the main source of information suggests a direct influence of the formal curriculum on the construction of knowledge, indicating that formal education is fulfilling its role. Practical experience, with almost half of the students having observed multiple cases of skin cancer in clinical stages, is essential for the consolidation of theoretical knowledge¹¹.

Despite the high recognition of the importance of regular dermatological examinations and awareness for risk groups, significant gaps were identified in the ability to differentiate melanoma and recognize malignant lesions with the ABCDE tool. Most feel only partially able to do it, which highlights the need for greater focus on practical diagnostic aspects during training. In addition, confidence in addressing the topic of skin cancer in medical consultations is still partial for more than half of the students, indicating the need for improvement in the transition from theoretical knowledge to clinical practice and communication with the patient^11),(12. From the point of view of medical education, the findings reveal a dissociation between theoretical knowledge and safety for practical application, especially in the recognition of suspicious lesions and in the preventive approach in consultations. This phenomenon is widely described in the educational literature as a gap between cognitive teaching and the development of clinical skills, reinforcing the need for active methodologies, case-based training, and greater integration between dermatological content and real practice scenarios during undergraduate studies¹³.

Furthermore, regarding the importance attributed to regular dermatological examinations, a significant association was observed with sex¹⁴. Women showed greater appreciation for this preventive practice, which may reflect greater concern with health and aesthetics. In addition, another factor that contributes to this is the strong integration of SPF in skin care products and cosmetics such as moisturizers, foundations, which are predominantly marketed and designed for the female audience. Added to this, the female cultural feeling that the application of sunscreen is not just about protection against neoplasms, but an act integrated into the beauty and skin care routine, with motivations linked to the prevention of photoaging and its manifestations - wrinkles, fine lines, sun spots - which constantly concern the female public and are targets of the media to capture this audience. In this sense, for women, the use of facial sunscreen is a beauty, preventive, and habitual behavior. For men, on the other hand, it is only a health behavior, often reactive and situational, reserved for occasions of high exposure, such as beach days or outdoor sports¹⁴.

Regarding indoor tanning, students demonstrated a heightened awareness of the negative role of the media and the associated risks, with strong support for the ban on tanning beds. However, the lack of access to detailed information about the risks of indoor tanning during their academic training is a concern, as these future professionals will need to educate their patients about the harms of the procedure and oncological dangers as they promote health education about skin neoplasms in primary care. The perception that patients’ awareness of the risks of artificial tanning has not increased significantly in recent years suggests that public health campaigns still need to be modernized and use devices with greater reach to young people, such as the media and social networks¹⁵.

Regarding the use of sunscreen, the students demonstrate a good knowledge of the meaning of SPF and the importance of the time of application and the amount for effectiveness. However, the misunderstanding of the difference between SPF 30 and SPF 50 is a notable gap, indicating the need for more in-depth education about the nuances of sun protection. The minority that knows the recommended amount by body part and the diversity of opinions about the most important time of day to apply also indicate areas for improvement in education¹⁶.

This study has some limitations that should be considered. The cross-sectional design prevents the inference of causality between knowledge and preventive practices. The convenience sample, restricted to two institutions in a single city, limits the generalization of the findings. In addition, the use of a self-reported questionnaire may be subject to recall bias and social desirability.

Although the study did not directly evaluate pedagogical strategies, the results suggest that traditional approaches may not be sufficient to consolidate competencies related to the prevention and early diagnosis of skin cancer, pointing to the potential of active methodologies in the medical curriculum. Among which we can mention realistic simulations such as OSCE (Objective Structured Clinical Examination), roleplay that allows the strengthening of doctor-patient communication and, consequently, health guidance, added to gamification and virtual quizzes that enhance visual memory and, consequently, the ability to identify suspicious lesions by students^17),(¹⁸.

Despite these limitations, the results offer relevant subsidies for the planning of educational strategies in medical courses, especially in regions of high sun exposure, and can guide curricular interventions and health promotion actions.

FINAL CONSIDERATIONS

Therefore, medical students in Parnaíba-PI have a good knowledge base about skin cancer and prevention. However, there are clear opportunities to enhance diagnostic skills, deepen knowledge about indoor tanning and the true differentials of sun protection factors, and increase confidence in addressing these issues in future medical consultations. To equip these future professionals with the precise knowledge and confidence necessary to educate their patients effectively, the findings indicate the need to review and strengthen pedagogical strategies throughout medical education. This may involve the inclusion of more practical modules, workshops focused on diagnosis and communication, and the integration of up-to-date information on best practices for skin cancer prevention and management. In addition, more in-depth studies are still needed to analyze other gaps involving knowledge of sun protection prevention and skin neoplasms. By doing so, we ensure that the next generation of doctors is not only informed, but also fully able to be an agent of change in public health, especially in a region such as Parnaíba-PI, where sun exposure is a constant reality. Moreover, the findings reinforce the need for continuous educational strategies integrated into the medical curriculum, focusing on clinical practice, patient communication, and public health prevention.

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  Evaluated by double blind review process.
• SOURCES OF FUNDING
  The authors declare no sources of funding.
• DECLARATION OF DATA AVAILABILITY
  Research data is only available upon request.

• Chief Editor:
  Rosiane Viana Zuza Diniz.

• Associate Editor:
  Roberto Esteves.

Data availability

Research data is only available upon request.

Publication Dates

• Publication in this collection
  28 Aug 2026
• Date of issue
  2026

History

• Received
  07 Apr 2026
• Accepted
  03 July 2026