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Sun Savvy Sadly Lacking Among Americans

Most people practice risky behaviors while under its glare, study finds

FRIDAY, Jan. 11 (HealthDay News) -- Think you're doing all you can to protect your skin when you're out in the sun? Think again.

Most people fall short, miserably short, in reducing their risk of getting skin cancer, a new study from Fox Chase Cancer Center in Philadelphia claims. Given that skin cancer rates have increased enough in the past 30 years to give it the dubious distinction of being the most common cancer in the United States, people might want to take more heed while basking in the sun's rays, the researchers note.

The majority of the U.S. population engages in multiple risky behaviors for skin cancer, according to the report. Among the worst offenders: young adults aged 18 to 29, men, Midwesterners, smokers, "risky" drinkers, whites, less-educated folks, and those whose skin isn't sun-sensitive.

The results, which are published in the February issue of the American Journal of Preventive Medicine, were met with disappointment by dermatologists who have been preaching sun safety for decades.

"This [study] shows how badly we are doing," said Dr. Clay Cockerell, a clinical professor of dermatology and pathology at the University of Texas Southwestern Medical Center at Dallas.

While many other studies have found that risky behaviors for skin cancer are common, few have investigated the behaviors across multiple age groups and focused on the presence of multiple risky behaviors, said study author Elliot Coups.

That was the goal of his team, which used data from the 2005 National Health Interview Survey of more than 28,000 U.S. adults. "We looked at five skin cancer risk behaviors," Coups said. They found the most common risk behaviors were infrequent use of protective clothing -- a wide-brimmed hat, long sleeves and long pants -- and infrequent use of sunscreen with a sun protection factor (SPF) of 15 or more.

The other three were staying in the sun when outside on a sunny day instead of seeking shade, use of indoor tanning devices, and having a history of sunburns.

"We also found that most individuals reported in engaging in two or more of the five risk factor behaviors," Coups said.

The worst age group, when it came to practicing risky behaviors, were those aged 18 to 29, Coups said, with 81.5 percent of them reporting two or more risky behaviors.

Among the 30- to 39-year-olds, 76.4 percent practiced two or more risky behaviors, and 70.3 percent of those aged 40 to 49 did. Among 50- to 64-year-olds, 60.4 percent admitted two or more risky behaviors, while 47.7 percent of those aged 65 and older did.

Men were more likely than women to ignore safe sun practices. Also more likely to practice risky sun behaviors were smokers and "risky" drinkers -- men who drank 15 or more drinks a week and women who drank eight or more drinks a week. Midwesterners, whites and those whose skin was not sun-sensitive were also more likely to skip sun precautions.

Dermatologists understandably find the results frustrating. "In spite of all the major efforts over the last 10 or 20 years, we haven't been making as much of an impact as we hoped," Cockerell said, noting that previous studies on sun protection behaviors have yielded similar findings.

The clustering of unhealthy behaviors -- such as smoking, drinking and not taking sun precautions -- may reflect a general attitude, he said. "I think it shows there is a segment of people who don't care much about their health," he added."

The findings correspond with the behaviors seen in patients, said Dr. Sandra Read, a dermatologist in private practice in Washington, D.C. The biggest mistake she sees in patients, she said, is infrequent and improper use of sunscreen. They don't apply it before they go out, she said, although applying is about 30 minutes before heading outside is recommended routinely.

"They don't apply enough," she added. A good guideline is to apply about a shot glass full, or about a golf ball-sized amount, to exposed skin. She tells patients to reapply it every two hours, more often if they perspire heavily or are in the water.

Read said most people know what they should do to reduce skin cancer risk -- but they don't always put what they know into practice. Many also have to give up the idea they look better with a little "color."

Another factor, Cockerell said, is that some experts advise some people to get a few minutes of unprotected sun exposure each day if they have a vitamin D deficit to boost their production of the "sunshine" vitamin.

"The problem with telling people to get 10 or 15 minutes [of sun] is that translates to an hour or more," he said.

More information

To learn more about sunscreens, visit the Skin Cancer Foundation.

SOURCES: Elliot Coups, Ph.D., assistant member, Fox Chase Cancer Center, Division of Population Science, Philadelphia; Clay Cockerell, M.D., past president, American Academy of Dermatology, clinical professor, dermatology and pathology, University of Texas Southwestern Medical Center at Dallas; Sandra Read, M.D., dermatologist, Washington, D.C.; February 2008, American Journal of Preventive Medicine

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