Skin care behaviors among melanoma survivors
ABSTRACT INTRODUCTION: Clinical recommendations for survivors of melanoma generally include skin care behaviors, including regular physician and skin self-examination to identify any recurrences or second primary disease early, as well as sun protection. We measured skin care behaviors in a population-based sample of melanoma survivors. METHODS: Melanoma survivors were approached through the regional National Cancer Institute-funded cancer registry (Surveillance, Epidemiology, and End Results) and recruited to this study with a response rate of approximately 75%, for a total sample of n = 313. RESULTS: The sample was 99% Caucasian, 56% female, 44% male, 81% married, 62% college educated, and 48% with an income over 70 K annually, with an average age of 56 years. Over the last 7 days, a total of 45% reported wearing sunscreen, 59% reported wearing long sleeves, 80% reported wearing pants, 35% reported wearing something on the head, and 36% stayed in available shade. Skin self-examination behaviors were reported at relatively low frequencies, with only 22% performing a thorough check on skin. A total of 88% of survivors reported that their physician checked their skin in the past few years by having all clothes removed. A multivariate analysis using logistic regression indicated that perceived risk was positively related to having the skin checked by a medical provider but no other skin protection behaviors. Gender effects were also detected for wearing sunscreen and wearing a hat or scarf. DISCUSSION: Data indicate that melanoma survivors are performing sun protection behaviors to a moderate extent. Future studies can address barriers to consistent use of these behaviors in melanoma survivors. Copyright © 2011 John Wiley & Sons, Ltd.
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ABSTRACT: Over 3 million new cases of skin cancer are diagnosed in the US annually. Melanoma, a subtype of skin cancer that can be fatal if the disease is not detected and treated at an early stage, is the most common cancer for those aged 25-29 years and the second most common cancer in adolescents and young adults aged 15-29 years. The primary carcinogen for the genesis of skin cancers is ultraviolet light from solar radiation and tanning beds. In spite of massive health campaigns to raise public awareness on ultraviolet radiation, sun-protective practices still fall behind. A plausible explanation is the lack of behavioral change in the populations at risk; in this review article, we examine sun-protective behavior in the four high-risk skin cancer groups: skin cancer survivors, individuals with a family history of melanoma, individuals with physical characteristics associated with skin cancer risk, and organ transplantation patients. Findings in the literature demonstrate that increased knowledge and awareness does not consequently translate into behavioral changes in practice. Behavior can differ as a result of different attitudes and beliefs, depending on the population at risk. Thus, intervention should be tailored to the population targeted. A multidisciplinary health team providing consultation and education is required to influence these much needed changes.Psychology Research and Behavior Management 12/2013; 7:9-18. DOI:10.2147/PRBM.S40457
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ABSTRACT: Background As the 10-year mortality for localized cutaneous melanoma more than 1.00 mm thick approaches 40% following complete resection, non-therapeutic interventions that can supplement recommended active surveillance are needed. Although guidelines recommending nutrition, physical activity and tobacco cessation for cancer survivors have been published, data describing their associations with melanoma survivorship are lacking. Methods Analysis of modifiable lifestyle behaviors collected on the 249 cases with melanomas more than 1.00 mm thick enrolled in the Connecticut Case–Control Study of Skin Self-Examination study was conducted. Independent associations with melanoma-specific survival were evaluated through Cox proportional hazards modeling adjusting for age, gender, Breslow thickness, ulceration and the presence of microsatellites. Independently significant variables were then combined into a single model and backwards elimination was employed until all remaining variables were significant at p < 0.05. Results Following adjustment for age, Breslow thickness and anatomic site of the index melanoma, daily fruit consumption was associated with improved melanoma-specific survival (HR = 0.54; 95% CI: 0.34–0.86) whereas at least weekly red meat consumption was associated with worse outcomes (HR = 1.84; 95% CI: 1.02–3.30). Natural red (HR = 0.44; 95% CI: 0.22–0.88) or blond (HR = 0.52; 95% CI: 0.29–0.94) hair were also favorably prognostic. Higher fish consumption was of borderline significance for improved survival only when considered independently (HR = 0.65; 95% CI: 0.40–1.05); no association was seen following adjustment for red meat and fruit consumption (p > 0.10). Conclusions Dietary choices at the time of diagnosis are associated with melanoma-specific survival in patients with melanomas more than 1.00 mm thick. Further validation of our findings in larger cohorts with repeated post-diagnostic measures is warranted to further evaluate whether dietary modification during the survivorship period can improve melanoma-specific survival.Cancer Epidemiology 10/2014; DOI:10.1016/j.canep.2014.08.005 · 2.56 Impact Factor
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ABSTRACT: Purpose Research suggests that physicians neglect preventive care for cancer survivors. A survivor's self-motivation with respect to preventive care is unknown. Using protective skin care as a proxy, our aims were to characterize preventive care in cancer survivors and to identify factors associated with appropriate prevention. Methods Using data from the 2009 U. S. Health Information National Trends Survey, we compared preventive skin care patterns in cancer survivors and non-cancer patients. Primary endpoints were the use of sunscreens, long-sleeved shirts, hats, and shade. Results We identified 179 early cancer survivors (< 5 years), 242 intermediate cancer survivors (5-10 years), 412 long-term cancer survivors (> 10 years), and 5951 non-cancer patients. The use of sunscreens (60%), long-sleeved shirts (88%), hats (58%), and shade (68%) was suboptimal. Overall, cancer survivors were not more likely to adhere to preventive care (p = 0.89). A composite score showed a significant difference between the cancer survivor groups (p < 0.01) whereby intermediate survivors reported the best preventive practices. Conclusions A prior diagnosis of cancer does not appear to increase personal compliance with cancer prevention. Reasons for this poor engagement are not clear. Targeted strategies to increase self-motivation might improve preventive practices in cancer survivors.08/2014; 21(4):e531-40. DOI:10.3747/co.21.1893