Sun behaviour after cutaneous malignant melanoma: a study based on ultraviolet radiation measurements and sun diary data

Idorn, Luise Winkel; Datta, Pameli; Heydenreich, Jakob; Philipsen, Peter Alshede; Wulf, Hans Christian

doi:10.1111/bjd.12066

Cited by 24 publications

(31 citation statements)

References 31 publications

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“…A small prospective study of melanoma survivors and controls found that UVR exposure was initially lower among survivors compared to controls but then converged over the three-year study. [23, 24]…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have included a control group[23, 24, 26, 35]; the largest to date compared 156 melanoma survivors to 11408 respondents without cancer who participated in 2005 and 2007 National Cancer Institute Health Information National Trends Surveys (HINTS). [26] Notably, the results were similar to our study, though HINTS respondents reported slightly lower frequencies of sunscreen use.…”

Section: Discussionmentioning

confidence: 99%

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

Vogel

Strayer

Engelman

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Introduction Melanoma is considered a generally preventable cancer, with excessive ultraviolet radiation (UVR) exposure being a strong causal factor. UVR exposure following a melanoma diagnosis can be modified to reduce risk of second primary melanomas. The goal of this study was to compare measures of UVR exposure and protection behaviors between long-term melanoma survivors and controls. Methods Participants from a previously conducted case-control study were recruited for a cross-sectional survey. Melanoma cases were 25–59 years old at diagnosis; controls were age and sex matched. Participants were asked about UVR exposure and protection measures used in the past year and comparisons between melanoma survivors and controls were conducted using logistic regression models, adjusting for potential confounders. Results A total of 726 (67.7%) long-term melanoma survivors and 657 (60.9%) controls completed the follow-up survey. Melanoma survivors were significantly less likely to report high sun exposure on a typical weekday (OR=0.72 [0.55–0.94]), sunburns (OR=0.40 [0.30–0.53]), or indoor tanning (OR=0.20 [0.09–0.44]) than controls; however high sun exposure on a typical weekend day was similar. Report of optimal sun protection behaviors were higher in melanoma survivors compared to controls. However, a few melanoma survivors reported indoor tanning, 10% reported intentionally seeking sun to tan, and 20% reported sunburns. Conclusion Although long term melanoma survivors reported healthier UVR exposure and protection behaviors compared to controls, a sizeable proportion still reported elevated sun exposure, sunburns, and suboptimal UVR protection behaviors. Impact Opportunities remain for improving sun protection to reduce future melanoma risk among melanoma survivors.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Vogel

Strayer

Engelman

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…CMM patients are likely to have changed their UVR exposure behaviour, at least immediately after diagnosis. 13,24 Additionally, CMM patients may be affected by recall bias regarding UVR exposure behaviour before CMM diagnosis, although there is some disagreement on this matter, especially regarding sunbathing and sunburns. [26][27][28] Hence, solar lentigines in patients with CMM cannot be expected to associate with current or past UVR exposure.…”

Section: Discussionmentioning

confidence: 99%

“…The recruitment and exclusion criteria of patients and controls have been described in detail elsewhere. 13 Controls. Forty-eight participants without skin cancer-in the following referred to as controls-participated.…”

Section: Participantsmentioning

confidence: 99%

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Black light visualized solar lentigines on the shoulders and upper back are associated with objectively measured UVR exposure and cutaneous malignant melanoma

Idorn

Datta

Heydenreich

et al. 2015

Photochem Photobiol Sci

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Previous studies on the association of solar lentigines with ultraviolet radiation (UVR) exposure have been based on retrospective questionnaires about UVR exposure. We aimed to investigate the association between solar lentigines and UVR exposure in healthy individuals using objective measurements, and to investigate the association between solar lentigines and cutaneous malignant melanoma (CMM). Forty-eight patients with CMM and 48 controls that matched the patients individually by age, sex, constitutive skin type and occupation participated. Solar lentigines on the shoulders and upper back were counted and graded into 3 categories using black light photographs to show sun damage. Current UVR exposure in healthy controls was assessed by personal electronic UVR dosimeters that measured time-related UVR and by corresponding exposure diaries during a summer season. Sunburn history was assessed by interviews. Among controls, the number of solar lentigines was positively associated with daily hours spent outdoors between noon and 3 pm on holidays (P = 0.027), days at the beach (P = 0.048) and reported number of life sunburns (P < 0.001). Compared with matched controls CMM patients had a higher number of solar lentigines (P = 0.044). There was a positive association between CMM and higher solar lentigines grade; Category III versus Category I (P = 0.002) and Category II versus Category I (P = 0.014). Our findings indicate that solar lentigines in healthy individuals are associated with number of life sunburns, as well as time spent outdoors around noon on holidays and beach trips during a summer season, most likely reflecting past UVR exposure, and that solar lentigines are a risk factor for CMM.

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A 3-Year Follow-up of Sun Behavior in Patients With Cutaneous Malignant Melanoma

et al. 2014

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IMPORTANCE UV radiation (UVR) exposure is the primary environmental risk factor for developing cutaneous malignant melanoma (CMM). OBJECTIVE To measure changes in sun behavior from the first until the third summer after the diagnosis of CMM using matched controls as a reference. DESIGN, SETTING, AND PARTICIPANTS Three-year follow-up, observational, case-control study performed from May 7 to September 22, 2009, April 17 to September 15, 2010, and May 6 to July 31, 2011, at a university hospital in Denmark of 21 patients with CMM and 21 controls matched to patients by sex, age, occupation, and constitutive skin type participated in the study. Exposure to UVR was assessed the first and second summers (n=20) and the first and third summers (n=22) after diagnosis. Data from 40 participants were analyzed. MAIN OUTCOMES AND MEASURES Exposure to UVR was assessed by personal electronic UVR dosimeters that measured time-related UVR in standard erythema dose (SED) and corresponding sun diaries (mean, 74 days per participant each participation year). RESULTS Patients' daily UVR dose and UVR dose in connection with various behaviors increased during follow-up (quantified as an increase in daily UVR dose each year; all days: mean, 0.3 SED; 95% CI, 0.05-0.5 SED; days with body exposure: mean, 0.6 SED; 95% CI, 0.07-1.2 SED; holidays: mean, 1.2 SED; 95% CI, 0.3-2.1 SED; days abroad: 1.9 SED; 95% CI, 0.4-3.4 SED; and holidays with body exposure: mean, 2.3 SED; 95% CI, 1.1-3.4 SED). After the second year of follow-up, patients' UVR dose was higher than that of controls, who maintained a stable UVR dose. No difference was found between groups in the number of days with body exposure or the number of days using sunscreen in the second and third years of follow-up. CONCLUSIONS AND RELEVANCE Our findings suggest that patients with CMM do not maintain a cautious sun behavior in connection with an increase in UVR exposure, especially on days with body exposure, when abroad, and on holidays.

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Sun behaviour after cutaneous malignant melanoma: a study based on ultraviolet radiation measurements and sun diary data

Abstract: Patients with CMM limited their UVR dose on days with body exposure, and by using sunscreen further reduced UVR reaching the skin, although only immediately after diagnosis.

Cited by 24 publications

References 31 publications

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

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

Black light visualized solar lentigines on the shoulders and upper back are associated with objectively measured UVR exposure and cutaneous malignant melanoma

A 3-Year Follow-up of Sun Behavior in Patients With Cutaneous Malignant Melanoma

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