In individuals with a history of melanoma, patients who are male, smokers, less educated, engage in tanning, and do not self-check their skin are less likely to adequately protect their skin in order to prevent future melanomas, according to study results published in the Journal of the American Academy of Dermatology.

The study included participants with clinical stage IB-II melanoma (n=789). The researchers assessed primary prevention behavior at diagnosis and then every 6 months for 2 years post-diagnosis. They used multivariable logistic and Cox-regression analyses to determine correlates of behavior trajectories and the risk for subsequent primary melanomas.

Of the participants, 448 were male and 341 were female. The researchers categorized sunscreen use as “stable, never-use” (26% males, 12% females), “stable, sometimes-use” (35% males, 29% females), and “increased to often-use” (39% males, 59% females).

While most participants reduced their weekend sun exposure after diagnosis, it remained raised in 82% of males and 69% of females.


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The researchers found that participants who used sunscreen inadequately (“stable, sometimes users” and “stable, never-users”) were older, more likely to never check their own skin, and less likely to have a university education.

During the follow-up period, 11% (n=75) of participants developed another primary melanoma. Most were men (63%), age >65 (66%), and receiving more frequent clinician skin checks after diagnosis (all P <.05).

Participants who had a history of melanoma pre-study with inadequate sunscreen use doubled their risk for another primary melanoma within the next 2 years (hazard ratio 2.45; 95% CI, 1.00-6.06). Sunscreen use was not, however, associated with the risk for another primary melanoma in participants without a melanoma history.

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“These findings should encourage clinicians to provide sun protection counselling to melanoma survivors and assist in identifying patients who would benefit from targeted education to reduce risk of further primary disease,” the researchers wrote.

Reference

von Schuckmann LA, Wilson LF, Hughes MCB, et al. Sun protection behaviour after diagnosis of high-risk primary melanoma and risk of subsequent primary. [published online July 15, 2018]. J Am Acad Dermatol. doi:10.1016/j.jaad.2018.06.068