Study: Many Skin Cancer Patients Still Frequently Get Sunburns

Individuals with previous nonmelanoma skin cancer (NMSC) are at increased risk for subsequent skin cancer and should therefore limit UV radiation exposure, according to a new study from researchers at Johns Hopkins University in Baltimore, Maryland.

In an effort to determine whether individuals with previous NMSC engage in better sun protection than those with no skin cancer history, the authors pooled self-reported data, culled from 2005 and 2010 National Health Interview Surveys, from US non-Hispanic white adults. Overall, 758 patients had previous NMSC, while 34,161 did not. Of the people without history, 18,933 were women and 15,228 were men, and of those with history, 390 were women and 368 were men.
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The investigators defined "protective practices" as using sunscreen when going outside on a sunny day for more than 1 hour, wearing long sleeves or a wide-brimmed hat, and staying in the shade when outside on a sunny day for longer than an hour. "Sun avoidance" was defined as not going out into the sun.

In total, 44.3% of individuals with NMSC history reported frequent use of shade, in comparison with 27% of those without a history of skin cancer, while 20.5% of individuals with a history of NMSC wore long sleeves, with just 7.7% of those with no history doing the same.

In addition, 26.1% of participants without a history of NMSC said they wore a wide-brimmed hat while in the sun, compared with 10.5% of those without a history. Meanwhile, 53.7% of patients with a history of NMSC indicated that they wore sunscreen, in comparison with 33.1% of those without a history.

Among participants with a histoy of NMSC, 44.7% said they use more than 1 form of sun protection. Only 19.4% of individuals without a history of NMSC said they take multiple skin-protective measures at a time. Multimodality was linked to lower odds of sunburn, according to the authors, who note that those with previous NMSC tend to use 1 or all of the aforementioned protective practices. Nevertheless, the researchers found no significant difference in the reporting of sunburn among those with a NMSC history compared with those without a history (29.7% vs 40.7%).

"Physicians should emphasize sunburn prevention when counseling patients with previous NMSC," the authors wrote, "focusing on shade and sun avoidance over sunscreen."

—Mark McGraw

Reference:
Fischer AH, Wang TS, Yenokyan G, Kang S, Chien AL. Sunburn and sun-protective behaviors among adults with and without previous nonmelanoma skin cancer (NMSC): A population-based study. J Am Acad Dermatol. 2016;75(2):371-379.e5. doi: http://dx.doi.org/10.1016/j.jaad.2016.02.1236.