Sun Exposure and Protection Habits in Pediatric Patients with a History of Malignancy.

Yael Levy-Shraga,Vered Temam,Dalit Modan-Moses,Rinat Cohen,Yonatan Yeshayahu,Michal Ben Ami,Maurice A M Van Steensel

doi:10.1371/journal.pone.0137453

Yael Levy-Shraga, Vered Temam + Show 5 more

Open Access

https://doi.org/10.1371/journal.pone.0137453

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Abstract

BackgroundSurvivors of childhood cancer are at high risk for developing non-melanoma skin cancer and therefore are firmly advised to avoid or minimize sun exposure and adopt skin protection measures. We aimed to compare sun exposure and protection habits in a cohort of pediatric patients with a history of malignancy to those of healthy controls.MethodsCase-control study of 143 pediatric patients with a history of malignancy (aged 11.2±4.6y, Male = 68, mean interval from diagnosis 4.4±3.8y) and 150 healthy controls (aged 10.4±4.8y, Male = 67). Sun exposure and protection habits were assessed using validated questionnaires.ResultsPatients and controls reported similar sun exposure time during weekdays (94±82minutes/day vs. 81±65minutes/day; p = 0.83), while during weekends patients spent significantly less time outside compared to controls (103±85minutes/day vs. 124±87minutes/day; p = 0.02). Time elapsed from diagnosis positively correlated with time spent outside both during weekdays (r = 0.194, p = 0.02) and weekends (r = 0.217, p = 0.01), and there was a step-up in sun exposure starting three years after diagnosis. There was no significant difference regarding composite sun protection score between patients and controls. Age was positively correlated with number of sunburns per year and sun exposure for the purpose of tanning, and was negatively correlated with the use of sun protection measures.ConclusionsAlthough childhood cancer survivors are firmly instructed to adopt sun protection habits, the adherence to these instructions is incomplete, and more attention should be paid to improve these habits throughout their lives. Since sunlight avoidance may results in vitamin D deficiency, dietary supplementation will likely be needed.

Highlights

Sun exposure is the major environmental risk factor for skin cancers, both melanoma and nonmelanoma [1]
Time elapsed from diagnosis positively correlated with time spent outside both during weekdays (r = 0.194, p = 0.02) and weekends (r = 0.217, p = 0.01), and there was a step-up in sun exposure starting three years after diagnosis
Age was positively correlated with number of sunburns per year and sun exposure for the purpose of tanning, and was negatively correlated with the use of sun protection measures

Summary

Introduction

Sun exposure is the major environmental risk factor for skin cancers, both melanoma and nonmelanoma [1]. Survivors of childhood and adolescent cancer, especially those who were treated with radiotherapy, are at a relatively high risk for developing non-melanoma skin cancer [6] and are firmly advised to avoid or minimize sun exposure and adopt skin protection measures such as applying sunscreen and wearing protective clothing, hats and sunglasses. In the current study we describe sun exposure and protection habits of pediatric patients with a history of malignancy compared to those of healthy children, and identify factors associated with sun behavior. Survivors of childhood cancer are at high risk for developing non-melanoma skin cancer and are firmly advised to avoid or minimize sun exposure and adopt skin protection measures. We aimed to compare sun exposure and protection habits in a cohort of pediatric patients with a history of malignancy to those of healthy controls

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Results

Conclusion