title: Sun exposure in young adult cancer survivors on and off the beach: results from Project REACH.
abstract: BACKGROUND
  Although cancer survivors are at risk for future skin cancers, many do not practice recommended sun protection. Studies have demonstrated poor adherence to specific behaviors (e.g., sunscreen, artificial tanning) during sunbathing, but less is known about survivors' typical amount of sun exposure during activities other than sunbathing.
  
  
  METHODS
  We conducted a mailed survey of 153 adults (median age = 26.1) diagnosed with a non-skin cancer before age 30. Information on recent sunbathing and incidental sun exposures, protective behaviors, and perceived vulnerability was collected. Analyses focused on characterizing survivors with the lowest levels of recommended sun protection.
  
  
  RESULTS
  Twenty-nine percent of participants exhibited low sun protection adherence during sunbathing and 31% during incidental exposure. Younger age was associated with low adherence, but this difference was significant only for sunbathing (OR=0.4; 95% CI, 0.2-0.9). Women were more likely than men to have low adherence during sunbathing (34.0% vs. 20.3%; OR = 2.44; 95% CI, 1.1-5.5). Survivors treated with radiation did not differ on exposures, adherence, or perceived vulnerability to the sun, despite feeling more susceptible to skin cancers (p = 0.03).
  
  
  CONCLUSIONS
  Despite known skin cancer risks, many young cancer survivors receive significant sun exposure. Assessment of sunbathing alone fails to capture sun exposure behaviors, particularly in men. Survivors treated with radiation may recognize their increased risk of skin cancer, but not the role of sun protection in modifying that risk.
authors: Perini Family Survivors' Center, Dana-Farber Cancer Institute/Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA.
authors: Eric K
authors: EK
authors: Zwemer
authors: Heike I M
authors: HI
authors: Mahler
authors: Andrew E
authors: AE
authors: Werchniak
authors: Christopher J
authors: CJ
authors: Recklitis
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004363:Drug Utilization / Q000706:statistics & numerical data; D004781:Environmental Exposure; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006184:Habits; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000532:radiotherapy; D011481:Protective Clothing / Q000706:statistics & numerical data; D011878:Radiotherapy / Q000523:psychology; D012959:Socioeconomic Factors; D055108:Sunbathing / Q000706:statistics & numerical data*; D013472:Sunlight; D013473:Sunscreening Agents; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data*; D013997:Time Factors; D055815:Young Adult
chemical_list: D013473:Sunscreening Agents