Top

Cancer Causes & Control

Published in:

01-07-2011 | Brief report

Hat, shade, long sleeves, or sunscreen? Rethinking US sun protection messages based on their relative effectiveness

Authors: Eleni Linos, Elizabeth Keiser, Teresa Fu, Graham Colditz, Suephy Chen, Jean Y. Tang

Published in: Cancer Causes & Control | Issue 7/2011

Abstract

Background

Sun protection messages in the United States emphasize sunscreen use, although its efficacy in skin cancer prevention remains controversial.

Methods

We used data from NHANES 2003–2006, restricted to adult whites (n = 3,052) to evaluate how Americans protect themselves from the sun. Participants completed questionnaires on the frequency with which they used sunscreen, wore a hat, long sleeves, or stayed in the shade, in addition to the number of sunburns in the past year.

Results

Although using sunscreen is the most common sun protective behavior (30%), frequent sunscreen use was not associated with fewer sunburns. However, the odds of multiple sunburns were significantly lower in individuals who frequently avoided the sun by seeking shade (OR = 0.70, p < 0.001) or wearing long sleeves (OR = 0.73, p = 0.01).

Conclusions

Our findings suggest that shade and protective clothing may be more effective than sunscreen, as typically used by Americans.

AAD. Be Sun Smart Campaign. http://www.aad.org/public/sun/smart.html

AMA. http://www.ama-assn.org/ama1/pub/upload/mm/39/sunteen.pdf

AMA American Medical Association. (2010) http://www.ama-assn.org/ama/pub/news/news/2010-new-policies.shtml

Green AC, Williams GM (2007) Point: sunscreen use is a safe and effective approach to skin cancer prevention. Cancer Epidemiol Biomarkers Prev 16(10):1921–1922PubMedCrossRef

Berwick M (2007) Counterpoint: sunscreen use is a safe and effective approach to skin cancer prevention. Cancer Epidemiol Biomarkers Prev 16(10):1923–1924PubMedCrossRef

Matsuoka LY, Ide L, Wortsman J, MacLaughlin JA, Holick MF (1987) Sunscreens suppress cutaneous vitamin D3 synthesis. J Clin Endocrinol Metab 64(6):1165–1168PubMedCrossRef

Green A, Williams G, Neale R, Hart V, Leslie D, Parsons P et al (1999) Daily sunscreen application and betacarotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: a randomised controlled trial. Lancet 354(9180):723–729PubMedCrossRef

Thieden E, Philipsen PA, Sandby-Moller J, Wulf HC (2005) Sunscreen use related to UV exposure, age, sex, and occupation based on personal dosimeter readings and sun-exposure behavior diaries. Arch Dermatol 141(8):967–973PubMedCrossRef

Autier P, Boniol M, Dore JF (2007) Sunscreen use and increased duration of intentional sun exposure: still a burning issue. Int J Cancer 121(1):1–5PubMedCrossRef

10.

Davis KJ, Cokkinides VE, Weinstock MA, O’Connell MC, Wingo PA (2002) Summer sunburn and sun exposure among US youths ages 11 to 18: national prevalence and associated factors. Pediatrics 110(1 Pt 1):27–35PubMedCrossRef

11.

CDC (2009) Centers for disease control and prevention, national center for health statistics. National health and nutrition examination survey data sets and related documentation. Internet: http://www.cdc.gov/nchs/nhanes/nhanes_questionnaires.htm

12.

Brown TT, Quain RD, Troxel AB, Gelfand JM (2006) The epidemiology of sunburn in the US population in 2003. J Am Acad Dermatol 55(4):577–583PubMedCrossRef

13.

Santmyire BR, Feldman SR, Fleischer AB Jr (2001) Lifestyle high-risk behaviors and demographics may predict the level of participation in sun-protection behaviors and skin cancer primary prevention in the United States: results of the 1998 National Health Interview Survey. Cancer 92(5):1315–1324PubMedCrossRef

14.

Hall HI, Saraiya M, Thompson T, Hartman A, Glanz K, Rimer B (2003) Correlates of sunburn experiences among US adults: results of the 2000 National Health Interview Survey. Public Health Rep 118(6):540–549PubMedCrossRef

15.

Holick MF (2009) Vitamin D status: measurement, interpretation, and clinical application. Ann Epidemiol 19(2):73–78PubMedCrossRef

16.

Cicarma E, Porojnicu AC, Lagunova Z, Dahlback A, Juzeniene A, Moan J (2009) Sun and sun beds: inducers of vitamin D and skin cancer. Anticancer Res 29(9):3495–3500PubMed

17.

Moan J, Porojnicu AC, Dahlback A, Setlow RB (2008) Addressing the health benefits and risks, involving vitamin D or skin cancer, of increased sun exposure. Proc Natl Acad Sci USA 105(2):668–673PubMedCrossRef

18.

Webb AR, Kift R, Durkin MT, O’Brien SJ, Vail A, Berry JL et al (2010) The role of sunlight exposure in determining the vitamin D status of the UK white adult population. Br J Dermatol 163(5):1050–1055PubMedCrossRef

19.

Samanek AJ, Croager EJ, Gies P, Milne E, Prince R, McMichael AJ et al (2006) Estimates of beneficial and harmful sun exposure times during the year for major Australian population centres. Med J Aust 184(7):338–341PubMed

20.

Sliney DH, Wengraitis S (2006) Is a differentiated advice by season and region necessary? Prog Biophys Mol Biol 92(1):150–160PubMedCrossRef

21.

Turnbull DJ, Parisi AV (2008) Optimizing solar UV-radiation exposures for vitamin D3: comparing global and diffuse spectral UV radiation. Radiat Res 169(3):344–349PubMedCrossRef

22.

Turnbull DJ, Parisi AV (2010) Latitudinal variations over Australia of the solar UV-radiation exposures for vitamin D3 in shade compared to full sun. Radiat Res 173(3):373–379PubMedCrossRef

23.

Green AC, Williams GM, Logan V, Strutton GM (2011) Reduced melanoma after regular sunscreen use: randomized trial follow-up. J Clin Oncol 29(3):257–263PubMedCrossRef

24.

Chang YM, Barrett JH, Bishop DT, Armstrong BK, Bataille V, Bergman W et al (2009) Sun exposure and melanoma risk at different latitudes: a pooled analysis of 5700 cases and 7216 controls. Int J Epidemiol 38(3):814–830PubMedCrossRef

25.

Gorham ED, Mohr SB, Garland CF, Chaplin G, Garland FC (2007) Do sunscreens increase risk of melanoma in populations residing at higher latitudes? Ann Epidemiol 17(12):956–963PubMedCrossRef

26.

Linos E, Swetter SM, Cockburn MG, Colditz GA, Clarke CA (2009) Increasing burden of melanoma in the United States. J Invest Dermatol 129(7):1666–1674PubMedCrossRef

27.

Ries (2008) Cancer Statistics Review 1975–2004. National Cancer Institute

28.

Rogers HW, Weinstock MA, Harris AR, Hinckley MR, Feldman SR, Fleischer AB et al (2010) Incidence estimate of nonmelanoma skin cancer in the United States, 2006. Arch Dermatol 146(3):283–287PubMedCrossRef

29.

Branstrom R, Kasparian NA, Chang YM, Affleck P, Tibben A, Aspinwall LG et al (2010) Predictors of sun protection behaviors and severe sunburn in an international online study. Cancer Epidemiol Biomarkers Prev 19(9):2199–2210PubMedCrossRef

Title: Hat, shade, long sleeves, or sunscreen? Rethinking US sun protection messages based on their relative effectiveness
Authors: Eleni Linos
Elizabeth Keiser
Teresa Fu
Graham Colditz
Suephy Chen
Jean Y. Tang
Publication date: 01-07-2011
Publisher: Springer Netherlands
Published in: Cancer Causes & Control / Issue 7/2011
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI: https://doi.org/10.1007/s10552-011-9780-1

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 7/2011

Green tea and coffee consumption and its association with thyroid cancer risk: a population-based cohort study in Japan

Dietary carbohydrate, glycemic index, glycemic load, and risk of prostate cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) cohort

Variation in the CYP19A1 gene and risk of colon and rectal cancer

Erratum to: Abuse victimization and risk of breast cancer in the Black Women’s Health Study

The association of diabetes mellitus and high-grade prostate cancer in a multiethnic biopsy series

Non-steroidal anti-inflammatory drugs (NSAIDs) and breast cancer risk: differences by molecular subtype

Keynote webinar | Spotlight on antibody–drug conjugates in cancer