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Survivors of melanoma are more likely to limit their exposure to ultraviolet radiation than those who have not had the disease, but more than 10% continue to intentionally tan, according to a study published in Cancer Epidemiology, Biomarkers and Prevention.1 The study surveyed 724 people diagnosed with melanoma (85.6% with stage I disease) 9.6 ± 1 years ago and 660 controls. Among the melanoma survivors, 10.4% intentionally spent time in the sun to get a tan vs 23.2% for controls, and 1.7% used an indoor tanning bed or booth, vs 6.8% for controls.

“Melanoma is serious, and not only survivors but the general population need to be taking sun protection and exposure more seriously,” the study’s lead author, Rachel Isaksson Vogel, PhD, told The ASCO Post. Dr. Vogel is Assistant Professor, Department of Obstetrics, Gynecology and Women’s Health, at the University of Minnesota, Minneapolis.

Trying to change the behavior of those intentionally seeking a tan “is a difficult issue,” she admitted. Those who are intentionally tanning are doing so “because of social norms with the belief that people look better or healthier with a darker tan.” That perception is a difficult thing to change, acknowledged Dr. Vogel.

Modifying the Risk

As Dr. Vogel and her coauthors noted in the introduction to their study: “Patients diagnosed with melanoma experience high rates of recurrence with an approximately 9-fold increased risk of developing another melanoma. Excess risk of recurrence remains 20 years after the initial diagnosis. For melanomas that develop as a consequence of ultraviolet radiation exposure, the damage done to the skin prior to the first melanoma cannot be ameliorated, and this damage may increase the risk of a subsequent melanoma. Importantly, however, ultraviolet radiation exposure following a melanoma diagnosis can be modified to reduce the risk of a new melanoma diagnosis.”

Melanoma survivors were less likely to spend 2 or more hours outside on weekdays during the summer but almost as likely to spend 2 or more hours outside on summer weekends. In addition to limiting exposure to the sun, melanoma survivors were more likely than controls “to report often or always engaging in sun protection behaviors,” the authors reported. These behaviors included using sunscreen, wearing a shirt with sleeves, wearing a hat, and staying in the shade in the summer.

Although sunscreen was the most frequently reported behavior, “sunscreen should not be the first step,” Dr. Vogel said. “These other options—protective clothing, staying in the shade—are much better at preventing excessive sun exposure than sunscreen is, mostly because generally we don’t use sunscreen properly.” Proper use of sunscreen would require more frequent and liberal application. ■

Disclosure: Dr. Vogel reported no potential conflicts of interest.


1. Vogel RI, Strayer LG, Engelman L, et al: Sun exposure and protection behaviors among long-term melanoma survivors and population controls. Cancer Epidemiol Biomarkers Prev 26:607-613, 2017.


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The more serious they perceived melanoma to be, the more likely they were to take it seriously and to make sure their behaviors aligned with that seriousness.
— Rachel Isaksson Vogel, PhD

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Long-term survivors of melanoma are more likely than those who...