Behavioral factors of patients before and after diagnosis with melanoma: a cohort study – are sun-protection measures being implemented?

Abstract

Melanoma is the deadliest form of all skin cancers and is highly linked to sun-related behavior in patients. However, sun-protection behavior to prevent melanoma in this population has been shown to be inadequate to date. The objective of this study was to compare changes in sun protection habit before and after patients' diagnosis with malignant melanoma. The study also seeks patients' advice on how to improve public education on melanoma prevention. A retrospective survey study was conducted on 68 respondents of patients diagnosed with melanoma from six different dermatologic practices in various boroughs of New York and Long Island in the state of New York by telephone interviews. There was a significant positive change in patients' sun-protection behavior after they were diagnosed with melanoma. Various methods of sun protection, such as avoiding sun exposure, applying and reapplying sunscreen, and wearing protective clothing were practiced more frequently after diagnosis. In addition, the frequency of sunbathing decreased drastically. Most patients were aware about the dangers of sun exposure before their diagnosis. They, however, did not feel the need to adopt sun-protection measures before their diagnosis. Respondents advised that education on dangers to excess sun exposure should be provided at an early age through multiple venues. The study reflected that 71% of diagnosed patients who completed the survey were informed about sun protection before their diagnosis. Many patients did not follow strict guidelines to prevent sun damage as shown by their behaviors before diagnosis. Diagnosis of the disease was apparently the main motivating factor to initiate challenging behavioral changes.

Sun Exposure and Protection Behaviors among Long-term Melanoma Survivors and Population Controls

“…A few studies have reported increases in sun-protection behaviors among melanoma patients following diagnosis. [30, 32, 36] Studies of melanoma survivors alone, one of which included longer-term survivors, found modest sun protection behaviors similar to our results. [10, 11] In comparison to non-cancer controls, two studies found that melanoma survivors use sunscreen and seek shade more frequently than controls,[26, 29] whereas another study found sun protection behaviors were similar to general population estimates.…”

Red meat and fruit intake is prognostic among patients with localized cutaneous melanomas more than 1mm thick

“…Nonetheless, the study of modifiable lifestyle factors with respect to melanoma prognosis is still sparse and has largely been restricted towards describing patterns of post-diagnosis ultraviolet light (UV) exposure and the associated risk of developing second primary melanomas [6, 16–19]. Even fewer published studies describe the association between modifiable lifestyle factors and recurrence of the index melanoma.…”

Rates of Sunburn Among Dermatology Patients

“…1 Therefore, it is essential that individuals with a history of skin cancer or other risk factors are able to successfully implement precautions to protect their skin. While studies show that many dermatology patients, particularly those who have a history of skin cancer, are motivated to engage in UVL protective behaviors, 2 it is unclear how successful they are in avoiding excessive UVL exposure (ie, frequency of sunburns). Patients who are motivated to use sun protection may encounter a range of barriers preventing the successful use of sunscreen that result in unintended sunburns (eg, they forget to reapply it).…”

“…Other patients do not use sun protection despite awareness of the risks associated with unprotected UVL exposure. 2 A recent study 3 found that dermatologists assessed patients’ sunscreen use in 30% of office visits involving a skin examination; however, they did not assess frequency of sunburns. Identifying patients who vary in their ability to successfully protect their skin and avoid sunburns is an important step in reducing overall risk by allowing physicians to provide behavioral intervention.…”