Evaluation of sun-protective behaviors in geriatric patients with and without skin cancer

Skin cancer is highly prevalent in older adults; however, data on real-world sun-protective behaviors in this population are limited. Although patients with skin cancer are routinely educated about sun protection, whether these recommendations are reflected in daily practice remains unclear. This study aimed to evaluate real-world sun-protective behaviors by comparing geriatric patients with and without a history of skin cancer.

Patients aged ≥65 years presenting to a tertiary-care dermatology outpatient clinic completed a structured questionnaire assessing sociodemographic factors and sun-protective behaviors. Histopathologically confirmed skin cancer type (basal cell carcinoma [BCC], squamous cell carcinoma [SCC], or malignant melanoma [MM]) was recorded. Sun-protective behaviors in the skin cancer group were assessed after diagnosis.

A total of 903 patients were included (441 women, 462 men; mean age 73.58 ± 7.47 years), of whom 161 (17.8%) had skin cancer. Patients with skin cancer reported higher sunscreen use and lower outdoor exposure between 10:00 and 16:00 compared with those without skin cancer (both p < 0.001). Sunglasses use and spending less than two hours in direct sunlight were more common in the non-skin cancer group (p = 0.016 and p < 0.001). Among patients with MM, sunscreen use was highest and outdoor exposure was lowest compared to other skin cancer types (p = 0.016 and p = 0.022, respectively).

Patients with skin cancer, particularly those with MM, reported greater use of sun-protective measures. However, these findings may reflect post-diagnosis behavioral changes and clinical counseling. Further research is needed to understand these behaviors and inform strategies for improving sun protection in older adults.