Lifestyle behaviors and sun exposure among individuals diagnosed with skin cancer: a cross-sectional analysis of 2018 BR
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Lifestyle behaviors and sun exposure among individuals diagnosed with skin cancer: a cross-sectional analysis of 2018 BRFSS data Ryan Ottwell 1 & Courtney Cook 1 & Benjamin Greiner 1 & Nguyen Hoang 2 & Tracy Beswick 3 & Micah Hartwell 1 Received: 29 June 2020 / Accepted: 17 November 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose With the continued increase in skin cancer incidence rates, the population of skin cancer survivors continues to grow. Understanding skin cancer survivors’ lifestyle behaviors, including ultraviolet radiation exposure, is important in reducing skin cancer recurrences and improving health outcomes. The objective of this study is to compare the differences in lifestyle behaviors among skin cancer survivors or individuals who currently have skin cancer versus individuals who have never had a skin cancer diagnosis. Methods To investigate these lifestyle behaviors, we performed a cross-sectional analysis comparing lifestyle behaviors in persons diagnosed with skin cancer and those without a history of skin cancer among US citizens using publicly available data from the 2018 Behavior Risk Factor Surveillance System (BRFSS). Results In total, there were 437,436 respondents. No significant difference existed between the two cohorts in sunburn frequency, use of sun protection, or indoor tanning; in fact, males were more likely to be afflicted with sunburns following diagnosis. Skin cancer survivors were less likely to be current smokers and sedentary. Female survivors were more likely to binge and heavily drink alcohol. Conclusion Our findings highlight important areas for reducing risk factors, which could reduce the recurrence of skin malignancies in skin cancer survivors. Implications for Cancer Survivors Our study provides insight to lifestyle behaviors among skin cancer survivors. Being aware of these behaviors has the potential to reduce skin cancer recurrence. Keywords Skin neoplasm . Skin cancer . Melanoma . General dermatology . Skin cancer survivors . Lifestyle behaviors . Lifestyle modifications . Public health . Sun protection . Ultraviolet radiation
Introduction One in five Americans will develop skin cancer in their lifetime, with an estimated 9500 people diagnosed daily, making skin cancer the most common form of cancer in the USA [1]. The incidence of non-melanoma—basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)—and melanoma skin cancers has continued to increase the past few decades in both the USA and worldwide, with most cases being
* Ryan Ottwell [email protected] 1
Oklahoma State University Center for Health Sciences, 1111 W 17th St, Tulsa, OK 74107, USA
2
University of Kansas School of Medicine, Kansas City, KS, USA
3
Center for Dermatology, Tulsa, OK, USA
preventable [2–7]. Fortunately, the two most common skin cancers, BCC and SCC, are highly curable with early detection and proper treatment [1, 8, 9]. Melanoma carries a higher mortality rate than non-melanoma skin cancers and is responsible for most skin
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