title: Melanoma survivors: health behaviors, surveillance, psychosocial factors, and family concerns.
abstract: BACKGROUND
  Little research has been conducted on melanoma survivors and important opportunities exist for research in this understudied population. The study objective was to examine experiences of melanoma survivors regarding sun protection, surveillance practices, psychosocial and family concerns using focus groups.
  
  
  METHODS
  We identified patients (≥ 18 years) treated at Memorial Sloan-Kettering Cancer Center (USA) during 1996-2005 with invasive primary cutaneous melanoma, stages I-III. We stratified focus groups by age (<50 vs ≥ 50 years) and years since diagnosis (1 to <5 years vs 5-10 years). We performed qualitative thematic text analysis, which involved independent data review by multiple analysts (n = 2) followed by interpretation of key findings via consensus work.
  
  
  RESULTS
  Forty-eight survivors composed the final sample. Most did not conduct routine skin self-examinations. Survivors became more conscious of sun exposure and expanded their sun protection; some experienced anxiety if caught unprotected in the sun. Survivors were aware of the increased melanoma risk for family members, yet many did not discuss risk reduction. Melanoma diagnosis elevated the importance of retaining health insurance and purchasing life insurance for younger survivors. We did not identify significance difference between those diagnosed more or less recently.
  
  
  CONCLUSIONS
  We identified areas of high priority to melanoma survivors: skin self-examination, anxiety associated with sun exposure, familial risk communication, and maintaining health insurance benefits. The implications for cancer survivors are that these behavioral data will help to design health promotion and prevention programs that are tailored to melanoma survivors' risk status.
authors.affiliation: Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10022, USA. oliveri1@mskcc.org
authors.forename: Susan A
authors.initials: SA
authors.lastname: Oliveria
authors.forename: Elyse
authors.initials: E
authors.lastname: Shuk
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Hay
authors.forename: Maureen
authors.initials: M
authors.lastname: Heneghan
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Goulart
authors.forename: Katherine
authors.initials: K
authors.lastname: Panageas
authors.forename: Alan C
authors.initials: AC
authors.lastname: Geller
authors.forename: Allan C
authors.initials: AC
authors.lastname: Halpern
mesh_terms: D000328:Adult; D005190:Family / Q000523:psychology; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology*; D008875:Middle Aged; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D040242:Risk Reduction Behavior; D016353:Self-Examination; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D013471:Sunburn / Q000517:prevention & control*; D013473:Sunscreening Agents / Q000008:administration & dosage; D017741:Survivors / Q000523:psychology*; D014481:United States
chemical_list: D013473:Sunscreening Agents