TY - JOUR
T1 - Sun protection behaviour after diagnosis of high-risk primary melanoma and risk of a subsequent primary
AU - von Schuckmann, Lena A
AU - Wilson, Louise F
AU - Hughes, Maria Celia B
AU - Beesley, Vanessa L
AU - Janda, Monika
AU - van der Pols, Jolieke C
AU - Smithers, B Mark
AU - Khosrotehrani, Kiarash
AU - Green, Adele C
N1 - Copyright © 2018. Published by Elsevier Inc.
PY - 2018
Y1 - 2018
N2 - BACKGROUND: Melanoma survivors are at high risk of further primary melanomas.OBJECTIVE: To assess sun behaviour after melanoma diagnosis and in relation to further primary melanomas.METHODS: We applied repeated measures latent class analysis to reported primary prevention behaviour at time of diagnosis and six-monthly for two years post-diagnosis in patients with clinical stage IB-II melanoma. Correlates of behaviour trajectories and risk of subsequent primaries were determined using multivariable logistic and Cox-regression analyses, respectively.RESULTS: Among 448 male and 341 female patients, sunscreen use fell into three trajectories: 'stable, never-use' (26% males; 12% females); 'stable, sometimes-use' (35% males; 29% females); 'increased to often-use' (39% males; 59% females). Most reduced their weekend sun exposure but in 82% of males and 69% of females it remained raised. Males, smokers, the less-educated, those who tanned or those not self-checking their skin, were more likely to have trajectories of inadequate protection. Patients with melanoma history pre-study doubled their risk of another primary melanoma in the next 2 years if sunscreen use in that time was inadequate (HR 2.45, 95% CI 1.00-6.06).LIMITATIONS: Patient-reported data susceptible to recall bias.CONCLUSION: Our results may assist clinicians to identify patients not using adequate sun protection and provide information for patient counselling.
AB - BACKGROUND: Melanoma survivors are at high risk of further primary melanomas.OBJECTIVE: To assess sun behaviour after melanoma diagnosis and in relation to further primary melanomas.METHODS: We applied repeated measures latent class analysis to reported primary prevention behaviour at time of diagnosis and six-monthly for two years post-diagnosis in patients with clinical stage IB-II melanoma. Correlates of behaviour trajectories and risk of subsequent primaries were determined using multivariable logistic and Cox-regression analyses, respectively.RESULTS: Among 448 male and 341 female patients, sunscreen use fell into three trajectories: 'stable, never-use' (26% males; 12% females); 'stable, sometimes-use' (35% males; 29% females); 'increased to often-use' (39% males; 59% females). Most reduced their weekend sun exposure but in 82% of males and 69% of females it remained raised. Males, smokers, the less-educated, those who tanned or those not self-checking their skin, were more likely to have trajectories of inadequate protection. Patients with melanoma history pre-study doubled their risk of another primary melanoma in the next 2 years if sunscreen use in that time was inadequate (HR 2.45, 95% CI 1.00-6.06).LIMITATIONS: Patient-reported data susceptible to recall bias.CONCLUSION: Our results may assist clinicians to identify patients not using adequate sun protection and provide information for patient counselling.
U2 - 10.1016/j.jaad.2018.06.068
DO - 10.1016/j.jaad.2018.06.068
M3 - Article
C2 - 30009865
SN - 0190-9622
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
ER -
