Sun protection behavior after diagnosis of high-risk primary melanoma and risk of a subsequent primary - 13/12/18
, Louise F. Wilson, MEpi a, Maria Celia B. Hughes, MMedSci a, Vanessa L. Beesley, PhD a, Monika Janda, PhD c, Jolieke C. van der Pols, PhD d, B. Mark Smithers, MBBS e, Kiarash Khosrotehrani, MD, PhD f, Adele C. Green, MBBS, PhD a, gAbstract |
Background |
Melanoma survivors are at high risk of further primary melanomas.
Objective |
To assess sun behavior after melanoma diagnosis and in relation to further primary melanomas.
Methods |
We applied repeated measures latent class analysis to reported primary prevention behavior at time of diagnosis and every 6 months for 2 years after diagnosis in patients with clinical stage IB or II melanoma. Correlates of behavior trajectories and risk of subsequent primaries were determined by using multivariable logistic and Cox regression analyses, respectively.
Results |
Among the 448 male and 341 female patients, sunscreen use fell into 3 trajectories: stable never-use (26% of males and 12% of females), stable sometimes-use (35% of males and 29% of females), and increased to often-use (39% of males and 59% of females). Most reduced their weekend sun exposure, but in 82% of males and 69% of females it remained increased. Males, smokers, the less educated, those who tanned, and those not self-checking their skin were more likely to have trajectories of inadequate protection. Patients with a history of melanoma before the study doubled their risk of another primary melanoma in the next 2 years if sunscreen use in that time was inadequate (hazard ratio, 2.45; 95% confidence interval, 1.00-6.06).
Limitations |
Patient-reported data are susceptible to recall bias.
Conclusion |
Our results may assist clinicians in identifying patients not using adequate sun protection and providing information for patient counseling.
Le texte complet de cet article est disponible en PDF.Key words : behavior, melanoma survivor, second primary, sun exposure, sun protection
Abbreviations used : LCA
Plan
| Funding sources: Supported by National Health and Medical Research Council (NHMRC) program grants 1073898 and 552429. Dr von Schuckmann was funded by NHMRC postgraduate scholarship 1133317, and Dr Khosrotehrani was funded by a NHMRC career development fellowship. The funding body played no role in study design; collection, analysis and interpretation of data; writing of the report; or the decision to submit the article for publication. |
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| Disclosure: Dr van der Pols received an honorarium from L'Oreal for a workshop consultation unrelated to this study. Dr von Schuckmann, Ms Wilson, Ms Hughes, Dr Beesley, Dr Janda, Dr Smithers, Dr Khosrotehrani, and Dr Green have no conflicts of interest to disclose. |
Vol 80 - N° 1
P. 139 - janvier 2019 Retour au numéro
Article précédent
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