Sun Protection Behaviors

Skin Cancer Prevention

Skin cancer is the most common type of cancer in the United States, and in contrast to many other cancers, its numbers are on the rise. Although skin cancer is the most common type of cancer, it is among the most preventable cancers. Comprehensive sun protection for skin cancer prevention includes (1) Avoiding sun exposure by attending to indicators of UV intensity and need for sun safety (i.e., time of day, season, latitude, altitude, and cloudiness); (2) Seeking shade whenever possible; (3) Wearing protective clothing that covers one’s trunk and arms such as a long-sleeve shirt, pants, and a wide-brimmed hat; (4) Applying sunscreen (SPF 15 or higher) 30 minutes before going outside in the sun; and (5) Reapplying sunscreen every 2 hours and after swimming or exercise. Avoiding outdoor and indoor tanning practices is also important for sunburn and skin cancer prevention. Indoor and outdoor tanning and sunburn have been strongly related to increased risk of melanoma.

The Health Behaviors Research Branch (HBRB) supports research in the area of sun protection and reducing sunburn and indoor tanning practices, through both measurement and intervention studies. HBRB is particularly interested in research leading to better understanding of sun safety and tanning practices in the context of other health behaviors (e.g., alcohol use), settings (e.g., physical activity), and social situations. HBRB also works to build collaborative partnerships with other government agencies and organizations to further scientific inquiry in how to best promote skin cancer prevention efforts at individual, community, and population levels.

Reports & Publications

Cancer Trends Progress Report: UV Exposure and Sun Protective Behavior

Perna FM, Dwyer LA, Tesauro G, Taber JM, Norton WE, Hartman AM, Geller AC. Research on Skin Cancer-Related Behaviors and Outcomes in the NIH Grant Portfolio, 2000-2014: Skin Cancer Intervention Across the Cancer Control Continuum (SCI-3C). JAMA Dermatol. 2017 May 1;153(5):398-405.

Geller AC, Dickerman BA, Taber JM, Dwyer LA, Hartman AM, Perna FM. Skin cancer interventions across the cancer control continuum: A review of experimental evidence (1/1/2000-6/30/2015) and future research directions. Prev Med. 2018 Jun;111:442-450.

Taber JM, Dickerman BA, Okhovat JP, Geller AC, Dwyer LA, Hartman AM, Perna FM. Skin cancer interventions across the cancer control continuum: Review of technology, environment, and theory. Prev Med. 2018 Jun;111:451-458.

U.S. Preventive Services Task Force. Final Recommendation Statement: Skin Cancer Prevention: Behavioral Counseling. 2018 March.

Robinson JK, Jablonski NG. Sun Protection and Skin Self-examination and the US Preventive Services Task Force Recommendation on Behavioral Counseling for Skin Cancer Prevention. JAMA. 2018 Mar 20;319(11):1101-1102.

Julian A, Thorburn S, Geldhof GJ. Health Beliefs About UV and Skin Cancer Risk Behaviors. Cancer Control. 2020 Jan-Dec;27(4):1073274819894008.

Robinson JK, Brown Z, Spring B. Melanoma Skin Self-Examination Education During Mammography: Health Burden of Women Impairs Implementation. J Cancer Educ. 2020 Feb 24:10.1007/s13187-020-01714-4.

Manne SL, Heckman CJ, Kashy D, Lozada C, Gallo J, Ritterband L, Coups EJ. Prevalence and correlates of skin self-examination practices among cutaneous malignant melanoma survivors. Prev Med Rep. 2020 May 1;19:101110.

Robinson JK, Reavy R, Mallett KA, Turrisi R. Remote skin self-examination training of melanoma survivors and their skin check partners: A randomized trial and comparison with in-person training. Cancer Med. 2020 Aug 6.

Geller AC, Jablonski N, Pagota S, Hay J, Hillhouse J, Buller D, Kenney WL, Robinson JK, Weller RB, Moreno MA, Gilchrest BA, Sinclair C, Arndt J, Taber J, Morris KL, Dwyer L, Perna F, Klein WMP, Suls J. Interdisciplinary Perspectives on Sun Safety and Skin Cancer Risk. JAMA Dermatol. 2018 Jan 1;154(1):88-92. doi: 10.1001/jamadermatol.2017.4201.

Andersen PA, Buller DB, Walkosz BJ et al. Expanding occupational sun safety to an outdoor recreation industry: a translational study of the Go Sun Smart program. Transl Behav Med 2012 Mar;2(1):10-18.

Baker, M. K., Hillhouse, J. J., & Liu, X. (2010). The effect of initial indoor tanning with mother on current tanning patterns. Arch Dermatol, 146(12), 1427-1428. doi: 146/12/1427 [pii]

Buller DB, Berwick M, Shane J, Kane I, Lantz K, Buller MK. (2013). User-centered Development of a Smart Phone Mobile Application Delivering Personalized Real-time Advice on Sun Protection. Transl Behav Med, 3(3): 326–334.

Heckman, C.J., Manne, S.L., Darlow, S., Cohen-Filipic, E., Kloss, P, Munshi, T., & Perlis, C. (2012). Psychosocial correlates of sunburn among young adult women. International Journal of Environmental Research and Public Health, 9: 2241-2251.

Hillhouse, J, Baker, MK, Turrisi, R, Shields, A, Stapleton, J, Jain, S, Longacre, I (2012). Evaluating a measure of tanning abuse and dependence. Archives of Dermatology.

Stapleton, J., Turrisi, R., Hillhouse, J., Robinson, J. K., & Abar, B. (2010). A comparison of the efficacy of an appearance-focused skin cancer intervention within indoor tanner subgroups identified by latent profile analysis. J Behav Med, 33(3), 181-190. doi: 10.1007/s10865-009-9246-z

Andersen PA, Buller DB, Walkosz BJ, Scott MD, Maloy JA, Cutter GR, Dignan MD. Environmental Cues to UV Radiation and Personal Sun Protection in Outdoor Winter Recreation . Arch Dermatol, Nov 2010; 146: 1241 - 1247.

Glanz et al. Measures of sun exposure and sun protection practices for behavioral and epidemiologic research . Arch Dermatol. 2008 Feb;144(2):217-22.

Holman DM, Ding H, Berkowitz Z, Hartman AM, Perna FM. Sunburn prevalence among US adults, National Health Interview Survey 2005, 2010, and 2015. J Am Acad Dermatol (2019).  

Manne SL, Coups EJ, Jacobsen PB, Ming M, Heckman CJ, Lessin S. Sun protection and sunbathing practices among at-risk family members of patients with melanoma. BMC Public Health. 2011; 11: 122.

Morris KL, Luke MC, Perna FM. Prevalence of Skin Cancer Examination Among Users of Indoor Tanning Beds. JAMA Dermatol (2018). 

Morris KL, Perna FM. Decision Tree Model vs Traditional Measures to Identify Patterns of Sun-Protective Behaviors and Sun Sensitivity Associated With Sunburn. JAMA Dermatol (2018).

Pagoto SL, Schneider KL, Oleski J, Bodenlos JS, Ma Y. The sunless study: a beach randomized trial of a skin cancer prevention intervention promoting sunless tanning . Arch Dermatol, Sept 2010; 146(9):979-84.

Selected Grants Funded in Areas Relevant to Skin Cancer Prevention

Resources

American Cancer Society Skin Cancer Facts