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

## TL;DR

This study finds that the general public has low awareness and underestimates the risk of keratinocyte carcinoma, a common skin cancer, highlighting the need for better health education.

## Contribution

The paper provides the first systematic review and meta-analysis on lay people's knowledge and risk perception of keratinocyte carcinoma.

## Key findings

- Only 20.75% of respondents were aware of basal cell carcinoma, the most common type of keratinocyte carcinoma.
- Respondents significantly underestimated the frequency of keratinocyte carcinoma, with only 7.21% identifying it as the most common skin cancer.
- Concern about developing keratinocyte carcinoma was reported by only 25–30% of respondents, indicating low risk perception.

## 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.