Association Between Education Level and Level of Knowledge of Skin Cancer among Basal Cell Carcinoma Patients at the Dr. Moewardi Hospital, Surakarta, Indonesia
DOI:
https://doi.org/10.26911/jepublichealth.2026.11.03.09Abstract
Background: Basal cell carcinoma (BCC) is a non-melanoma skin cancer from basal cells. Limited knowledge of risk factors and prevention contributes to BCC. This study examined the relationship between knowledge of skin cancer and education level in BCC patients at the Dermatology and Venereology Outpatient Clinic, Dr. Moewardi General Hospital.
Subjects and Method: A cross-sectional study was conducted on 64 BCC patients diagnosed clinically and histopathologically from January 2022 to December 2024. The study was conducted at the Dermatology and Venereology Outpatient Clinic of Dr. Moewardi General Hospital, Surakarta, Central Java, Indonesia. Sample were recruited using a consecutive sampling. The dependent variable was the level of skin cancer knowledge. The independent variable was education level. Data were analyzed using a multiple logistic regression.
Results: Education level was significantly associated with skin cancer knowledge after adjustment for age (OR= 7.26; 95% CI= 3.45–86.45; p<0.001).
Conclusion: Education level is significantly associated with skin cancer knowledge. Strengthening skin cancer education for low-education, high-exposure groups may support earlier detection and prevention.
Keywords:
basal cell carcinoma, skin cancer, knowledge, awareness, education levelHow to Cite
References
Baba PUF, Hassan Au, Khurshid J, Wani AH (2024). Basal cell carcinoma: diagnosis, management and prevention. J Mol Pathol. 5(2):153-170. https://doi.org/10.3390/jmp5020010
Bauer A, Haufe E, Heinrich L, Seidler A, Schulze HJ, Elsner P, Drexler H, et al. (202). Basal cell carcinoma risk and solar UV exposure in occupationally relevant anatomic sites: do histological subtype, tumor localization and Fitzpatrick phototype play a role? A population-based case-control study. J Occup Med Toxicol. 15:28. https://doi.org/10.1186/s12995-020-00279-8.
Chen H, Cohen P, Chen S. (2010). How big is a big odds ratio? Interpreting the magnitudes of odds ratios in epidemiological studies. Commun Stat Simul Comput. 39(4): 860–864. https://doi.org/10.1080/03610911003650383.
Ciążyńska M, Olejniczak-Staruch I, Sobo-lewska-Sztychny D, Narbutt J, Skibiń-ska M, Lesiak A. (2021). Ultraviolet Radiation and Chronic Inflammation-Molecules and Mechanisms Involved in Skin Carcinogenesis: A Narrative Review. Life. 11(4):326. https://doi.-org/10.3390/life11040326.
Darjania T, Kituashvili T, Galdava G. (2024). The impact of education level on basal cell carcinoma development risk. Cureus. 16(6): e61827. https://doi.org/10.7759/cureus.61827.
Dika E, Scarfì F, Ferracin M, Broseghini E, Marcelli E, Bortolani B, Campione E, et al. (2020). Basal Cell Carcinoma: A Comprehensive Review. Int J Mol Sci. 21(15):5572. https://doi.org/10.3390-/ijms21155572.
Knecht-Gurwin K, Stefaniak AA, Chlebicka I, Szepietowski JC. (2024). Basal Cell Carcinoma: Comprehensive Review with Emphasis on Scar Tissue Manifestation and Post-Vaccination Incidence. Biomedicines. 12(8): 1769. https://doi.org/10.3390/biomedicines12081769.
Krakowski AC, Hafeez F, Westheim A, Pan EY, Wilson M. (2022). Advanced basal cell carcinoma: what dermatologists need to know about diagnosis. J Am Acad Dermatol. 86(6): S1–S13. https://doi.org/10.1016/j.jaad.2022.03.023.
Lang BM, Balermpas P, Bauer A, Blum A, Brölsch GF, Dirschka T, Follman M, et al. (2019). S2k guidelines for cuta-neous basal cell carcinoma – Part 1: epidemiology, genetics and diagnosis. J Dtsch Dermatol Ges. 17(1): 94–103. https://doi.org/10.1111/ddg.13733.
Naik PP, Desai MB (2022). Basal cell carcinoma: a narrative review on contemporary diagnosis and management. Oncol Ther. 10(2): 317–335. https://doi.org/10.1007/s40487-022-00201-8.
Nicoara D, Pop IC, Muntean MV, Ilies RA, Nan R, Achimas-Cadariu PA. (2025). The role of prevention and early detection in skin tumors: correlation between educational level and tumor stage at diagnosis. J Clin Med. 14(20): 7321. https://doi.org/10.3390/jcm1-4207321.
Niculet E, Craescu M, Rebegea L, Bobeica C, Nastase F, Lupasteanu G, Stan DJ, et al. (2021). Basal cell carcinoma: comprehensive clinical and histo-pathological aspects, novel imaging tools and therapeutic approaches (review). Exp Ther Med. 23(1): 60. https://doi.org/10.3892/etm.2021.10982.
Peris K, Fargnoli MC, Kaufmann R, Aren-berger P, Bastholt L, Seguin NB, Bataille V, et al. (2023). European consensus-based interdisciplinary guideline for diagnosis and treatment of basal cell carcinoma—update 2023. Eur J Cancer. 192: 113254. https://-doi.org/10.1016/j.ejca.2023.113254.
Seité S, Del Marmol V, Moyal D, Friedman AJ (2017). Public primary and secondary skin cancer prevention, perceptions and knowledge: an inter-national cross-sectional survey. J Eur Acad Dermatol Venereol. 31(5): 815–820. https://doi.org/10.1111/jdv.141-04.
Szewczyk M, Pazdrowski J, Golusiński P, Dańczak-Pazdrowska A, Łuczewski Ł, Marszałek S, Majchrzak E, et al. (2016). Basal cell carcinoma in farmers: an occupation group at high risk. Int Arch Occup Environ Health. 89(3): 497–501. https://doi.org/10.-1007/s00420-015-1088-0.
Tang Y, Epstein E, Oro AE. (2019). Basal cell carcinoma and basal cell nevus syndrome. In: Kang S, et al. (eds). Fitzpatrick’s dermatology. 9th ed. New York: McGraw-Hill Education.
Toha S, Rahman A, Mochtar M, Julianto I, Dharmawan N, Mawardi P, Wasita B, et al. (2019). Kejadian karsinoma sel basal di RSUD Dr. Moewardi Surakarta berdasarkan subtipe histopatologi menurut jenis kelamin, usia, lokasi anatomi, dan diameter tumor. Cermin Dunia Kedokteran, 46(4): 256–260. https://doi.org/10.5-5175/cdk.v46i4.478.
Wibawa LP, Andardewi MF, Kristianti IA, Arisanty R. (2019). The epidemiology of skin cancer at Dr. Cipto Mangun-kusumo National Central General Hospital from 2014 to 2017. J Gen Proced Dermatol Venereol Indones. 4(1): 11–16. https://doi.org/10.19100-/jdvi.v4i1.162.
Wilvestra S, Lestari S, Asri E (2018). Studi retrospektif kanker kulit di Poliklinik Ilmu Kesehatan Kulit dan Kelamin RS Dr. M. Djamil Padang periode tahun 2015–2017. J Kesehat Andalas. 7(0): 47. https://doi.org/10.25077/jka.v7i-0.873.


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