Sunburn and sun-protective behaviors among adults with and without previous nonmelanoma skin cancer (NMSC): A population-based study

J Am Acad Dermatol. 2016 Aug;75(2):371-379.e5. doi: 10.1016/j.jaad.2016.02.1236. Epub 2016 May 16.

Abstract

Background: Individuals with previous nonmelanoma skin cancer (NMSC) are at increased risk for subsequent skin cancer, and should therefore limit ultraviolet exposure.

Objective: We sought to determine whether individuals with previous NMSC engage in better sun protection than those with no skin cancer history.

Methods: We pooled self-reported data (2005 and 2010 National Health Interview Surveys) from US non-Hispanic white adults (758 with and 34,161 without previous NMSC). We calculated adjusted prevalence odds ratios (aPOR) and 95% confidence intervals (CI), taking into account the complex survey design.

Results: Individuals with previous NMSC versus no history of NMSC had higher rates of frequent use of shade (44.3% vs 27.0%; aPOR 1.41; 95% CI 1.16-1.71), long sleeves (20.5% vs 7.7%; aPOR 1.55; 95% CI 1.21-1.98), a wide-brimmed hat (26.1% vs 10.5%; aPOR 1.52; 95% CI 1.24-1.87), and sunscreen (53.7% vs 33.1%; aPOR 2.11; 95% CI 1.73-2.59), but did not have significantly lower odds of recent sunburn (29.7% vs 40.7%; aPOR 0.95; 95% CI 0.77-1.17). Among those with previous NMSC, recent sunburn was inversely associated with age, sun avoidance, and shade but not sunscreen.

Limitations: Self-reported cross-sectional data and unavailable information quantifying regular sun exposure are limitations.

Conclusion: Physicians should emphasize sunburn prevention when counseling patients with previous NMSC, especially younger adults, focusing on shade and sun avoidance over sunscreen.

Keywords: multimodal sun protection; nonmelanoma skin cancer; photoprotection; skin cancer prevention; sunburn; sunscreen; ultraviolet exposure.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Health Behavior*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / prevention & control
  • Skin Neoplasms* / prevention & control
  • Sunburn / prevention & control*
  • Sunscreening Agents / therapeutic use*
  • Young Adult

Substances

  • Sunscreening Agents