Knowledge Levels of Kindergarten Teachers About Skin Cancer, Sun Protection Behaviors, and Affecting Factors Adem Sümen 1 & Selma Öncel 2 # American Association for Cancer Education 2020 Abstract The aim of this study was to determine the knowledge level of kindergarten teachers regarding skin cancer, the sun protection behaviors they exhibit for themselves/their students, and the affecting factors. This descriptive study was carried out in the Mediterranean region in a province located by the sea. The universe of the study consisted of 181 teachers working in kindergartens, and data were collected from the 81% who agreed to participate in the study. The mean Skin Cancer and Sun Knowledge Scale of the teachers was 12.50 ± 3.27 (range 0–25) and the mean Sun Protection Behavior Scale score was 24.78 ± 6.26 (range 8–40). When the Sun Protection Behavior Scale sub-dimensions were analyzed, the teachers’ mean score of refraining from the sun was 13.02 ± 2.02, sunscreen use was 9.88 ± 4.46, and hat use was 5.13 ± 2.52. Significant positive correlations were found between the teachers’ knowledge scores and refraining from the sun (r = 0.222; p = 0.007) and sunscreen use (r = 0.243; p = 0.003). The least used sun protection practice of the teachers regarding the students was wearing sunglasses (64.8%) and the most used practice was remaining in the shade (75.9%). The level of teachers’ knowledge about skin cancer and sun protection and their behavior regarding sun protection for themselves were moderate, but the sun protection behaviors they use for their students were inadequate. Thus, educational programs about sun exposure are needed in schools and non-formal education institutions. Keywords Child . Kindergarten . Kindergarten teacher . Skin neoplasms . Sunscreen factor . Skin cancer prevention Introduction The importance of sunrays for the continuation of life in the world is an undeniable fact, but solar-induced ultraviolet (UV) radiation also has harmful effects on human health. Skin can- cers are the main problem in this regard. Studies show that 90% of non-melanoma skin cancers and 63% of melanomas result from UV-rays [1]. Although everyone is at risk of de- veloping skin cancer, people with light skin, with a large num- ber of moles and spots, exposed to the sun for a long time, and with a sunburn history in childhood are more prone to develop skin cancer [2]. Reasons such as tanning becoming fashion- able among people, the psychological effect of a beautiful appearance, familial behavioral models (for example, the thought that burned skin is healthy), and an increase in vaca- tions and similar activities increase the effect of UV-rays on human health [3]. After discovering intensive UV-rays during childhood pro- motes the development of skin cancers, especially melanoma, it became clear that sun protection should be a habit that starts in childhood [4]. Developing positive behaviors for sun pro- tection and reducing exposure to UV radiation in sunlight is important to reduce the burden of skin cancer in public health [5]. Regardless of skin phototype, sun protection behavior needs to be cultivated in all children. Regular protection from the sun in childhood and adolescence reduces the lifelong incidence of skin cancer [6]. Because the harmful effects of sunlight are especially high in childhood, it is very important to create sun protection awareness at an early age [4]. Sümen and Öncel [7] evaluated 47 studies assessing skin cancer and students and found stu- dents are effectively protected when informed by their teachers. Teachers’ behaviors regarding sun protection posi- tively correlate with the general perceptions of children and their families [8]. School settings are very important because * Adem Sümen ademsumen@akdeniz.edu.tr 1 Department of Public Health Nursing, Kumluca Faculty of Health Sciences, Akdeniz University, Antalya, Turkey 2 Department of Public Health Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey Journal of Cancer Education https://doi.org/10.1007/s13187-020-01804-3