Skin cancer and sun protective behaviours in water-based sports: A scoping review

Individuals who participate in outdoor sports are subject to an increased risk of developing skin cancer. To date, there has been no review examining skin cancer and sun protective behaviours specific to outdoor, water-based sports. Therefore, this scoping reviews objectives were to (a) summarize volume and type of the scientific literature available relating to skin cancer, (b) examine current sun protective behaviours and (c) identify knowledge gaps to inform future research.

A scoping review was conducted to address the objectives following the PRISMA guidelines. Seven databases were searched; identified studies were screened based on title, abstract and full text for outdoor water-based sports, which examined skin cancer and/or sun protective behaviours. Data were extracted, synthesized and critically appraised using a modified AXIS tool. Percentage frequencies were calculated, and key results were placed in tabular or graphical presentation.

Nine cross-sectional studies were identified, all defined as low-level evidence. A combined sample of 4377 participants across six countries and five water-based sports showed BCC (71%) was the most common skin cancer, followed by melanoma (18%) and SCC (10%). The head (41%) and upper limbs (27%) were the most common location.

This review highlights the minimal research available and demonstrates those in water-based sports are at high risk of developing skin cancer. Due to difficulty adhering to sun protective behaviours, the most prevalent location is the upper body. Included studies were of low-level evidence, providing opportunity for future research to expand upon the gaps in the current literature.