Purpose and Background: African Americans, in comparison to other ethnic groups, are often diagnosed with melanoma at advanced stages, resulting in low survival rates. One of the strongest risk factors for all types of skin cancer is exposure to UV radiation from the sun. UV ray intensity is associated with latitude; lower latitudes have stronger UV rays than higher latitudes. This study examines and compares the knowledge, attitude, and protective behavior toward skin cancer among United

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... African American college students who live in two different latitudes, Maryland and southern California. Methods: We surveyed 360 African American students from two major universities in southern California and Maryland. Students were asked to fill out questionnaires that assessed their knowledge, attitude, and protective behavior regarding sun exposure. Results: More African American students from Maryland knew the direct link between UV/sun radiation exposure and the occurrence of skin cancer (p = 0.02), while those from California were significantly more knowledgeable about skin cancer risk factors such as sunbathing without sunscreen (p ≤ 0.001). Although students from Maryland were more concerned that exposure to the sun may give them skin cancer (p = 0.003) and more worried about the possibility of skin cancer (p < 0.001), they were less likely to engage in sun protection behaviors such as using sunscreen (p = 0.001). Conclusion: Based on this study, efforts to increase sun protective behaviors through education regarding skin cancer risk factors in Maryland are warranted.