Supplementary Material for: Adherence to Primary Prevention and Skin Self-Examination Practices by Spanish Melanoma Patients

<b><i>Background:</i></b> The incidence of cutaneous melanoma, an important global public health problem, has been increasing over the last several decades. <b><i>Objectives:</i></b> In order to decrease melanoma-related mortality, ways to communicate and implement the correct methods for conducting primary and secondary prevention measures (such as early detection via self-examination) should be investigated. <b><i>Materials and Methods:</i></b> An observational, cross-sectional, retrospective study consisting of 409 patients diagnosed with cutaneous melanoma was conducted. An online questionnaire was created to evaluate knowledge levels, attitudes, and adherence to primary preventive measures and to skin self-examination practices. <b><i>Results:</i></b> The results revealed that even when 43% of the patients perform cutaneous self-examinations, only half of them fully followed the recommendations. Patients aged &lt;45 years, female, with a I–II phototype, with an intermediate/high level of education, and with a history of NMSC were more likely to have an adequate degree of knowledge. Moreover, patients aged &lt;45 years and with an adequate degree of knowledge more frequently showed an adequate adherence to the primary prevention measures. Finally, patients aged 45–60 years and with an adequate degree of knowledge presented a good adherence to the self-skin examination measures. <b><i>Limitations:</i></b> Possible limitations of this study were memory bias through the influence of age within the study population, and bias due to a greater proportion of subjects with a high education level. <b><i>Conclusion:</i></b> Within the population of patients with melanoma, a high percentage of patients do not rigorously follow the recommended prevention measures. Our study highlights the need to implement awareness in this population to improve the prevention of cutaneous cancer.

**背景：** 皮肤黑色素瘤是一项重要的全球公共卫生问题，近数十年来其发病率持续攀升。
**目的：** 为降低黑色素瘤相关死亡率，需探究传播并落实一级、二级预防措施（如通过自我检查实现早期筛查）的正确方法。
**材料与方法：** 本研究为观察性横断面回顾性研究，纳入409名确诊皮肤黑色素瘤的患者。通过自制线上问卷评估受试者的知识水平、态度及对一级预防措施与皮肤自我检查行为的依从性。
**结果：** 研究结果显示，尽管有43%的患者会进行皮肤自我检查，但仅半数能够完全遵循推荐方案。年龄小于45岁、女性、皮肤光类型I~II型、受教育程度中等/高等且有非黑色素瘤皮肤癌（NMSC, Non-Melanoma Skin Cancer）病史的患者，更易具备充足的疾病相关知识。此外，年龄小于45岁且知识储备充足的患者，对一级预防措施的依从性更高。最后，年龄45~60岁且知识储备充足的患者，对皮肤自我检查措施的依从性更佳。
**局限性：** 本研究存在两项潜在局限性：其一，研究人群的年龄因素可能引发回忆偏倚；其二，受试人群中高教育水平者占比偏高，可能引入偏倚。
**结论：** 在黑色素瘤患者群体中，仍有较高比例的患者未严格遵循推荐的预防措施。本研究强调，需在该群体中开展健康宣教，以提升皮肤癌的预防效果。