title: The association between skin characteristics and skin cancer prevention behaviors.
abstract: BACKGROUND
  Behaviors such as sunscreen use and wearing sun-protective clothing are thought to prevent certain types of skin cancer and precancerous lesions, but few studies have examined differences in these prevention behaviors by skin type.
  
  
  METHODS
  We carried out a cross-sectional study (n = 6,858) nested within a community-based prospective cohort in Washington County, Maryland. We measured the associations between skin type, complexion, freckling, and eye color, and sunscreen and sun-protective clothing use.
  
  
  RESULTS
  The prevalence of regular sunscreen use was 23% and regular sun-protective clothing use was 21%. There were consistent trends indicating those with the most sun-sensitive skin type were most likely to engage in prevention behaviors. For example, compared with those who tan without burning, those who develop blistering sunburns were more likely to use sunscreen [odds ratio (OR), 6.04; 95% confidence interval (95% CI), 2.82-12.95 men; OR, 4.89; 95% CI, 3.34-7.16 women] and sun-protective clothing (OR, 2.87; 95% CI, 1.71-4.80 men; OR, 4.44; 95% CI, 2.88-6.85 women). Health-related characteristics such as body mass index and cigarette smoking were also significantly inversely associated with prevention behaviors.
  
  
  CONCLUSIONS
  The overall prevalence of prevention behaviors was low. Those with phenotypic risk factors for skin cancer were most likely to use sunscreen and sun-protective clothing. Those with high-risk skin cancer phenotypes may also be those who are most receptive to skin cancer prevention educational interventions.
authors.affiliation: Department of Biostatistics, Bioinformatics, and Epidemiology, Hollings Cancer Center, Medical University of South Carolina, 86 Jonathan Lucas Street, Post Office Box 250955, Charleston, SC 29425, USA.
authors.forename: Lee
authors.initials: L
authors.lastname: Wheless
authors.forename: Ingo
authors.initials: I
authors.lastname: Ruczinski
authors.forename: Rhoda M
authors.initials: RM
authors.lastname: Alani
authors.forename: Sandra
authors.initials: S
authors.lastname: Clipp
authors.forename: Judith
authors.initials: J
authors.lastname: Hoffman-Bolton
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Jorgensen
authors.forename: Nanette J
authors.initials: NJ
authors.lastname: Liégeois
authors.forename: Paul T
authors.initials: PT
authors.lastname: Strickland
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Alberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D011446:Prospective Studies; D011481:Protective Clothing; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D018709:Statistics, Nonparametric; D013471:Sunburn / Q000453:epidemiology / Q000517:prevention & control; D013472:Sunlight / Q000009:adverse effects; D013473:Sunscreening Agents / Q000627:therapeutic use
chemical_list: D013473:Sunscreening Agents