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Review
. 2025 Aug 6;13(15):1912.
doi: 10.3390/healthcare13151912.

Knowledge and Risk Perception Regarding Keratinocyte Carcinoma in Lay People: A Systematic Review and Meta-Analysis

Luisa Leonie Brokmeier  1   2 , Laura Ilic  1 , Sophia Haas  1 , Wolfgang Uter  1 , Markus Vincent Heppt  3   4   5 , Olaf Gefeller  1 , Isabelle Kaiser  1
Affiliations
Review

Knowledge and Risk Perception Regarding Keratinocyte Carcinoma in Lay People: A Systematic Review and Meta-Analysis

Luisa Leonie Brokmeier et al. Healthcare (Basel). .

Abstract

Background/objectives: The increasing incidence rates of keratinocyte carcinoma (KC), particularly in fair-skinned populations, call for efforts to intensify health education of the general population in addressing this prevalent skin cancer type. As a preparatory step, this systematic review summarizes the published research on the knowledge and risk perception regarding KC among individuals without medical training.

Methods: The review was registered in PROSPERO (CRD42024618851) and adheres to PRISMA guidelines. The databases PubMed, Scopus, Web of Science, PsycArticles, and PsycINFO were searched on 30 July 2024. Studies were eligible if knowledge and/or risk perception was assessed in lay people. Risk of bias (ROB) was assessed with the Joanna Briggs Institute checklist for prevalence studies. Comparable outcomes (e.g., awareness of terms for KC) were meta-analyzed.

Results: Included reports (n = 17) were published between 1991 and 2024 with 16,728 individuals assessed. Awareness for the most common type of KC, basal cell carcinoma (BCC), was low (20.75% of respondents (95% confidence interval (CI): 15.24-27.61)), while more respondents were familiar with colloquial terms (60.9-72.8%). Meta-analysis indicated an underestimation of the frequency of KC, with only 7.21% (CI: 4.03-12.58) identifying BCC as the most common type of skin cancer. Furthermore, concern about developing KC as assessed in only two overlapping studies was reported by only 25-30% of respondents, indicating a significant gap in risk awareness and a lack of research on risk perception regarding KC.

Conclusions: This review highlights the need for targeted health education interventions to improve knowledge and preventive behaviors regarding KC. Given the limitations of the included studies, characterized by high ROB, heterogeneity of results, and a lack of standardized assessment tools, further research is essential to enhance the understanding and awareness of KC in diverse populations.

Keywords: basal cell carcinoma; concern; keratinocyte carcinoma; knowledge; prevention; risk perception; skin cancer; squamous cell carcinoma.

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Conflict of interest statement

L.L.B was the author of one of the included studies in this systematic review. Therefore, this study and the one using overlapping data were screened, extracted, and evaluated regarding ROB by two other independent researchers. Otherwise, the authors declare no pertinent conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart of the systematic literature review process.
Figure 2
Figure 2
Forest plot with meta-analysis showing the proportions of the awareness of the term basal cell carcinoma (BCC). CI: Confidence interval [30,46,47,49,50,54,55].
Figure 3
Figure 3
Forest plot with meta-analysis showing the proportions of the identification of basal cell carcinoma (BCC) as a type of cancer. CI: Confidence interval [29,44,45,52,58].
Figure 4
Figure 4
Forest plot with meta-analysis showing the proportions of the identification of squamous cell carcinoma (SCC) as a type of cancer. CI: Confidence interval [29,44,45,58].
Figure 5
Figure 5
Forest plot with meta-analysis showing the proportions of the identification of basal cell carcinoma (BCC) as the most common type of cancer. CI: Confidence interval [51,53,57].
See this image and copyright information in PMC

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