Sun-related behavior after a diagnosis of cutaneous malignant melanoma

Cutaneous malignant melanoma is a significant public health problem in Western countries, and the probability that patients with one melanoma will develop a second one is high. This study is an attempt to assess and understand sun-related behavior in patients subsequent to a melanoma diagnosis. We recruited 35 melanoma patients diagnosed in 2001 or 2002, who resided in the Greater Vancouver Regional District of British Columbia, Canada, and 35 controls frequency matched by broad age-group, sex, ethnicity, and area of residence to patients. All participants were interviewed over the telephone in the autumn of 2003 to ascertain their outdoor activities for the previous summer months (June-August) of 2003, along with their clothing preferences, sunscreen use, sunburn frequency, and knowledge and attitudes regarding sun exposure and tanning. Patients were less involved in outdoor recreational activities than controls (mean monthly hours 23.0 vs. 31.0, P=0.023). In addition, patients protected themselves from sun exposure using clothing and sunscreen more often than controls. However, the data also revealed that patients still engaged in outdoor activities to a substantial degree, often without sun protection. Furthermore, 27% still had a positive or neutral attitude toward tanning, even after melanoma diagnosis. The continuing presence of unprotected episodes of summer sun exposure in patients with melanoma, coupled with sunburn prevalence similar to normal controls, suggests that better education and behavior modification programs are needed for patients with melanoma. The results may indicate the need for more emphasis on post-treatment counseling by physicians.