Sun-protective behaviours in US adults with a history of skin cancer: a cross-sectional National Health Interview Survey study.

BACKGROUND

Individuals with a history of skin cancer are at elevated risk for subsequent malignancies, underscoring the importance of sustained photoprotective behaviours. However, little is known about how these behaviours evolve over time following diagnosis.

OBJECTIVES

To assess the prevalence of sun-protective behaviours among adults with and without a history of skin cancer and to evaluate whether adherence varies based on time since diagnosis.

METHODS

We conducted a cross-sectional analysis using pooled data from the 2005-15 National Health Interview Survey. Weighted estimates were used to compare photoprotective behaviours, including sun avoidance, use of protective clothing, sunscreen application, use of tanning devices and sunburn history, between respondents with and without a history of skin cancer, stratified by years since diagnosis. Multivariate logistic regression was used to assess adjusted odds ratios (aORs).

RESULTS

Individuals with a history of skin cancer reported significantly higher use of sunscreen and protective clothing, and lower use of tanning devices than controls. Behaviours varied over time, and those with 1-4 years or ≥10 years since diagnosis had a significantly higher odds of using protective clothing compared with controls (adjusted OR 3.17, 95% confidence interval 1.35-7.46 for 1-4 years; adjusted OR 2.42, 95% confidence interval 1.22-4.79 for ≥10 years).

CONCLUSIONS

Photoprotective behaviours varied by time since diagnosis, with peak adherence seen 1-4 years postdiagnosis. Photoprotection improves after skin cancer diagnosis but may change over time, supporting the need for ongoing patient education.