Some Melanoma Survivors Still Practice Unsafe Sun Behaviors

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Although long-term melanoma survivors were more likely to report healthier levels of ultraviolet radiation (UV) exposure and sun protection behaviors than controls, some still reported indoor tanning or intentionally seeking sun to tan, according to the results of a recent study published in Cancer, Epidemiology, Biomarkers & Prevention.

“While a melanoma diagnosis may serve as a trigger for behavior change for many, resulting in better sun protection among survivors compared with controls, one-fifth of survivors experienced sunburn in the past year and many reported engaging in suboptimal sun protection behaviors,” wrote Rachel Isaksson Vogel, PhD, of the University of Minnesota, and colleagues. “These data suggest that interventions are needed to further improve sun behaviors and reduce future risk of skin cancer in this population.”

In order to examine UV radiation exposure and other sun-related behaviors among long-term melanoma survivors, Vogel and colleagues recruited participants from a previously conducted case-control study of people with melanoma aged 25 to 59 years at diagnosis. The study included 724 survivors who were compared with 660 age- and sex-matched controls. Participants completed a follow-up survey that asked about UV radiation exposure and protection measures used in the past year.

Melanoma survivors were significantly more likely than controls to report optimal sun exposure behaviors, with the exception of sun exposure on the weekends in the summer. Survivors were less likely to spend more than 1 hour outside on weekdays (32.3% vs 44.4%; P = .01; odds ratio [OR], 0.72; 95% CI, 0.55–0.94), less likely to report a sunburn in the past year (19.5% vs 36.5%; P < .0001; OR, 0.40; 95% CI, 0.30–0.53), and less likely to have indoor tanned (1.7% vs 6.8%; P < .0001; OR, 0.20; 95% CI, 0.09–0.44) or intentionally tanned (10.4% vs 23.2%; P < .0001) in the last year.

“While long-term melanoma survivors were less likely to report indoor tanning in the past year than controls, a small number of survivors reported still engaging in this behavior,” the researchers wrote. “This phenomenon has been reported elsewhere and indicates a small proportion of individuals will continue this high-risk behavior despite a melanoma diagnosis.”

Survivors also reported more sun protection behaviors than controls, including wearing sunscreen (P < .0001), a shirt with sleeves (P < .0001), and a hat (P = .01).

The researchers acknowledged that these self-reported outcomes may have been over-reported by participants “due to social desirability, particularly among melanoma survivors, resulting in an overestimate of sun protection behaviors.”

Another study limitation, according to the authors “is that survivors who responded to our survey may be more likely to practice health behaviors, or those who are still alive may be those who frequently use optimal sun protection behaviors.”

Based on these data, the researchers concluded that opportunities still exist for improving sun protection behaviors and reducing risk for second melanomas among melanoma survivors.