Children’s knowledge and behavior towards the sun and photo protection (Survey of 391 children in the region of Fez, Morocco)

Background: Currently, the sun-cancer relationship is well established and it is clearly demonstrated that sun exposure during childhood increases the risk of skin cancer in later life. The main objective of our study was to evaluate the behavior and knowledge of children towards the sun, its dangers, particularly skin cancer, and the different means of photo protection. Material and methods: We conducted a descriptive cross-sectional survey using a questionnaire among students (primary and secondary) in the region of Fez (urban and rural). Results: Three hundred and eightyone children delivered a completed and usable questionnaire. The average age was 13 years, the sex ratio M/F =1,16. 71,9% of the children were from public schools and 66% had moderately pigmented skin. Among the 97% of children who practice outdoor activities during the vacations, 30.5% like to tan, and almost half spend more than 30 minutes a day under the sun. 69.6% of the children declared that they take with them during the vacations at least one sun protection product (sun cream, hat, sunglasses…) Concerning the application of sunscreen,72.2% of children used sunscreen during their vacations, 27.7% reapply it every two hours and 82.4% apply it only in summer. At school, 72.6% of the students said they look for shade during recess and only 10% apply sun cream. 55, 8% of the children think that the sun can be dangerous, 44.2% know that there is a relationship between the sun and skin cancer, 52% think that the sun can cause burns and 37% skin aging. 71% said they have already been told by a parent that they should protect themselves from the sun,41.5% were advised by their teachers and only 31% by a doctor.43% of our children had heard of skin cancer and almost half of these children know that it can be caused by the sun. In general, the assessment of children's knowledge was average in about half of the cases, we noted that children are better protected during the summer vacations than at school. We also focused on the role of parents, schools, doctors and media in raising children's awareness, which was not sufficient.