III-Assessment of Skin Cancer Risk Factors

1. Have you ever smoked?

a. Yes b. No

2. How many packets do you smoke per year? packet/year

3. Overall, how long did you smoke?…year(s)…month(s)

4. Have you ever been exposed to the sun for a long period?

a. Yes b. No

If yes, how long?…hour(s)…mn(s).

5. Have you ever undergone a radiological examination?

a. Yes b. No

6. Have you ever worked in a printing company?

a. Yes b. No If yes, how long? hour(s) mn(s).

7. Have you ever worked in a petrol station or have you ever been in contact for long with fuel or oil ?

a. Yes b. No

8. Have you ever been in contact with pesticide?

a. Yes b. No

9. Do you have a chronic wound (Chronic ulceration)?

a. Yes b. No

10. Do you have a hyperpigmented mark on your body? (naevus, beauty spot, Wend bobélé)

a. Yes b. No

If yes, for how long do you have it?.

11. Are you immunosuppressed (HIV, immunosuppressive treatment)?

a. Yes b. No c. Does not know

IV-Assessment of Knowledge of Skin Cancer Risk Factors

Please, answer by yes or no if these factors are skin cancer risk factors or not.

1. Smoke cigarette: True False

2. Long exposure to the sun: True False

3. Professional exposure: True False

4. Cosmetic products containing hydroquinone: True False

5. Albinism: True False

6. Immunodepression (HIV): True false

7. History of personal skin cancer: True False

8. Burn scar: True False

9. Chronic wound: True False

10. Hyperpigmented mark: True False

11. Hypersensitiveness to the sun: True False