Sun protection and skin self-examination in melanoma survivors

Objectives: Patients diagnosed with melanoma are at risk for developing recurrent and second primary disease. Skin self-examination (SSE) and sun protection are standard clinical recommendations to minimize risk. In this study we examined performance of these behaviors in individuals with melanoma drawn from the general population. Methods: Potential participants (N = 148) with a first primary melanoma diagnosed in 2000 were identified through a population-based cancer registry in New Jersey, USA. One hundred and fifteen individuals participated in a 30 min telephone interview concerning behavioral adherence with SSE and sun protection, self-efficacy for performing these behaviors, and perceived risk of developing another skin cancer. We utilized logistic regression to estimate potential associations of demographic, medical, and psychosocial factors with SSE and sun protection, respectively. Results: Seventeen percent of subjects reported performing comprehensive SSE at least once every two months and 23% engaged in regular sun protection. Utilization of SSE was related to the presence of moles (OR = 4.2, 95% CI: 1.1-15) and higher SSE self-efficacy (OR = 14.4, 95% Cl: 1.9-112). Regular sun protection was related to older age (> 60 years; OR = 3.3, 95% CI: 1.3-8.7), being female (OR = 2.8, 95% CI: 1.1-7.3), and higher sun protection self-efficacy (OR = 5.0, 95% CI: 1.4-18). These factors remained significant in multivariate models. Conclusion: In this group of primary melanoma survivors, the rates of SSE and sun protection are comparable to, but do not exceed, general population estimates. This study provides justification for further research to address barriers to prevention and control behaviors in melanoma survivors. Copyright (C) 2009 John Wiley & Sons, Ltd.