One-Quarter of Melanoma Survivors Never Wear Sunscreen.

• Keypoint Tweet @CentralSkin:  Melanoma, tanning beds, and no sunscreen: not a sunny combination.

• What:  Research out of Yale School of Medicine shows the good, the bad, and the ugly of the habits of melanoma survivors.

  • ​​The Good:  Melanoma survivors are more likely to engage in sun protective habits than the general public.

  • The Bad:  More than one-quarter of melanoma survivors do not use sunscreen.

  • The Ugly:  More than 2% of melanoma survivors use tanning beds.  

• ​Melanoma Facts:  Melanoma is the most dangerous form of skin cancer. The American Cancer Society estimates that in 2013, 76,690 new cases of melanoma will be diagnosed and 9,480 people are expected to die from melanoma.  Melanomas originate in melanocytes, the pigment producing cells in the skin.  Ultraviolet radiation in the form of sun or tanning beds leads to DNA damage in skin cells and causes mutations which can lead to malignant melanoma.  Whites are 20 times more likely to be diagnosed with melanoma in their lifetime than African Americans.  Overall, 1 out of every 50 whites (or 2%) will get diagnosed with melanoma in their lifetime.  Unlike most other cancers, a significant number of young people are diagnosed with melanoma.  This makes melanoma one of the most common cancers in young adults, and especially young women.

• What do I need to know about this study?  It was conducted by Anees Chagpar, MD, MPH, an associate professor of surgery at Yale School of Medicine.  Dr. Chagpar and colleagues conducted a retrospective study in which they analyzed data from the 2010 National Health Interview Survey, an annual cross-sectional survey of people in the United States which asks questions on a wide range of health topics.  They focused on responses which dealt with the sun protection habits of melanoma survivors as compared to individuals never diagnosed with melanoma.  The data was presented in the American Association of Cancer Research Annual Meeting 2013, held in Washington D.C. on April 6 through the 10th, 2013.  

• ​What are they saying about this?  Dr. Chagpar states, "We know that melanoma is a malignancy prevalent in our population, and we know that for many people with melanoma, sun exposure is a major risk factor for recurrence and sun protection may reduce their chance of getting melanoma again." The results of the study surprised Dr. Chagpar, "Although we found that melanoma survivors did better than the general public at protecting their skin from the sun, we also found that more than a quarter of melanoma survivors never wear sunscreen. That blew my mind."

• ​Show me the numbers:  Of the 27,120 adults who were surveyed, 171 had a prior history of melanoma.  

The encouraging results when comparing melanoma survivors to individuals with no history of melanoma:

1. Melanoma survivors were more likely to stay in the shade (15.6% vs. 10.5% of the general population).
2. Melanoma survivors were more likely to wear a baseball cap/visor (31.3% vs. 18.4%), a wide-brimmed hat (20.5% vs. 6.1%), and/or a long-sleeved shirt (12% vs. 5.2%) when outside on a sunny day for more than one hour.
3. Melanoma survivors were more likely to always wear sunscreen (32% vs. 17.2%).

The discouraging results: 

1. 15.4% of melanoma survivors reported that they rarely or never stay in the shade.
2. 27.3% of melanoma survivors reported to never wear sunscreen when going outside on a sunny day for more than one hour (as compared to 35.4% of the general population).
3. 2.1% reported using a tanning bed during the previous year (compared with 5.5% of the general population).

• What are the caveats to this study?  One caveat is the relatively low number of melanoma survivors who were part of the survey.  While a very large number of the general population was tallied, the study only consisted of 171 melanoma survivors.  When comparing such small percentages as 2.1% of 171 vs. 5.5% of 27,120, one realizes that there may have been sampling error in the melanoma survivors group.  Also, this study was presented at a medical conference and has not yet been rigorously reviewed by a scientific journal, the gold standard of medical and scientific research.

• The bottom line:  The general population in the United States needs to be more cognizant of good sun protection habits, such as using sunscreen with an appropriate SPF, avoiding tanning beds, and using sun protective clothing.  By doing these things, you are engaging in primary prevention against skin cancer, i.e. preventing skin cancer from forming in the first place.  However, when it comes to melanoma survivors, they are now in the business of secondary prevention, i.e. preventing the melanoma from relapsing or new melanoma from forming.  And while melanoma survivors tend to have better sun protective habits than the general population, they are still significantly lacking according to the results of this study.  This presents an opportunity to increase education of melanoma survivors (and the general population) on wearing sunscreen and other appropriate sun protective habits.  

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