Knowledge, attitude, and practice towards sunscreen use, sun protective behavior, and skin cancer among Lebanese medical students and residents

Skin cancer is the most common malignancy worldwide, and melanoma accounts for the majority of skin cancer–related deaths. Medical students and residents play an essential role in prevention through patient counseling and role modeling. This study aimed to assess knowledge, attitudes, and practices regarding sunscreen use, sun-protective behaviors, and skin cancer among Lebanese medical students and residents, and to identify predictors of these outcomes. This cross-sectional study was conducted between April 29 and June 15, 2023, among 1,063 Lebanese medical students and residents. Data were collected using an English-language online questionnaire distributed via WhatsApp and Instagram using snowball sampling. The survey assessed sun-protective behaviors using stages of change, attitudes using the Decisional Balance Scale (DBS) and Self-Efficacy Scale (SES), and knowledge of sunscreen and skin cancer. Multivariate linear regression models were used to identify independent predictors of DBS, SES, and knowledge scores. Overall, 75.2% of participants reported sunscreen use, yet 78.6% reported prior sunburn. Participants demonstrated moderate knowledge (53.23 ± 14.31%), decisional balance (14.15 ± 3.64/20), and self-efficacy (26.39 ± 7.40/45). Positive correlations were observed between DBS, SES, and knowledge scores ( r = 0.219–0.547, p < 0.001). Multivariate analysis showed that higher knowledge was independently associated with higher academic year, prior sunburn, higher SES, higher household income, private university affiliation, and advanced sunscreen use stage (adjusted R² = 0.214). Higher DBS scores were associated with higher SES, sunscreen use, female gender, higher knowledge, and advanced behavioral stage (adjusted R² = 0.405). Higher SES was associated with higher DBS, sunscreen use, and advanced behavioral stage (adjusted R² = 0.366). Lebanese medical students and residents demonstrated moderate knowledge and attitudes but a high prevalence of sunburn, indicating a gap between knowledge and preventive behavior. Preventive competencies were strongly associated with academic progression, behavioral readiness, and self-efficacy. Integrating structured, stage-specific sun protection education early in medical training may improve preventive behaviors and strengthen physicians’ role in skin cancer prevention.