Patients with previous non-melanoma skin cancer get sunburned as much as those without cancer

Patients with a history of non-melanoma skin cancer (NMSC) may not be properly or effectively using sun protection measures such as sunscreen, according to researchers at Johns Hopkins University School of Medicine, Baltimore, MD, who found that many of these patients still get sunburned, and at rates similar to individuals without a past history of skin cancer. They recommended, therefore, that clinicians take time to properly instruct these patients about using multiple forms of sun-protection, as well as effective use and application of sunscreens.

They published their results in May, ahead of print, in the Journal of the American Academy of Dermatology.

“It is important to look at how patients are currently practicing sun protection and what they are doing that is not very effective,” says Anna Chien, MD, co-director of the Cutaneous Translational Research Program in the Department of Dermatology at the Johns Hopkins University School of Medicine. “Only then can we make strides in helping patients improve their sun protective practices by ensuring they do them the correct way,” she added.

Using pooled self-reported data from the 2005 and 2010 National Health Interview Surveys from 758 non-Hispanic white adults with previous NMSC (390 female, 368 male) and 34,161 without (18,933 female, 15,228 male), Dr. Chien and colleagues found that those with a previous NMSC had higher rates of frequent use of shade compared with those with no history of NMSC (44.3% vs 27.07%; adjusted prevalence odds ratio [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).

In addition, 44.7% of those with a history of NMSC reported using more than one form of sun protection, compared with 19.4% of those without a history of NMSC.

Importantly, however, despite the greater use of one or all protective practices by individuals with a previous history of NMSC, there was no significant difference in the reporting of sunburn compared with individuals without a history (29.7% vs 40.7%, respectively; aPOR 0.95; 95% CI 0.77-1.17); and in these individuals, recent sunburn was inversely associated with age, sun avoidance, and shade, but not sunscreen.

“These results suggest that physicians need to go the extra step in educating patients on the most optimal way of utilizing sun protection methods. Public health messages should also emphasize not only sun protection but how to do it correctly,” said Dr. Chien.

“The bottom line is that people should be using multiple forms of skin protective practices,” she said. “That means incorporating shade or sun avoidance into a daily routine, or wearing a wide-brimmed hat while also applying sunscreen correctly,” she concluded.