Despite the documented increased use of sunscreen and protective clothing in recent years, up to 66% of young adults are still getting sunburned at least once a year.
The use of tanning beds also continues, according to the May 11 issue of the Morbidity and Mortality Report. A review of the National Health Information Survey found that up to 44% of women in the subgroup analysis reported using the devices in 2010, and that those who tan indoors do so up to 28 times each year. Even people with a family history of skin cancer or with recent sunburns are using the devices, said Anne Hartman, a biostatistician with the National Cancer Institute.
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In the survey, 50% of respondents reported at least one sunburn during the past 12 months.
The findings are worrisome on a number of levels, said Dr. Daniel M. Siegel, president of the American Academy of Dermatology.
"It is distressing that the study found tanning bed use is higher in those with a family history of skin cancer and that sunburn prevalence remains high," he said in an interview. "This emphasizes how important it is to educate the public and encourage them to change their behaviors as they do not necessarily understand the dangers of sun exposure and indoor tanning. If they do, the risks may not be discouraging the behavior."
The sun protection study extracted data from 5 years of the National Health Interview Survey (NHIS). The survey includes detailed questions on sun exposure, the use of sunscreens and protective clothing, and other sun-protective behaviors from the 2000-2010 surveys (MMWR Morb. Mortal. Wkly. Rep. 2012;61:317-22).
Overall, 50% of respondents reported at least one sunburn during the past 12 months. This was highest among whites (66% in 2010) and lowest among blacks (11% in 2010). A similar number of men and women reported getting sunburned, and the prevalence of burning did not differ from 2000 to 2010 (about 50% each year).
Women were most likely to report sunscreen use and staying in the shade (37% and 35%, respectively). Sunscreen use increased significantly from 2000 to 2010, as did the use of clothing to the ankles (21% in 2000 and 26% in 2010). There were also significant increases in the practice of seeking shade (29% and 35%, respectively). However, there were no significant increases in the use of wide-brimmed hats or long-sleeved shirts.
White women were more likely to report shade use, with a significant increase each year. Black women were least likely to report using sunscreens each year.
Men most often reported using long clothing and staying in the shade (33% and 26%, respectively). Shade use among men increased from 18% in 2000 to 26% in 2010. Long protective clothing use increased from 28% to 33%, but changes in sunscreen use were not significant over that time, nor were changes in wearing a long-sleeved shirt or wide-brimmed hat.
Clinicians and policy-makers can help improve these behaviors by continuing to stress the importance of sun protection, Ms. Hartman said. "Evidence from a recent review by the U.S. Preventive Services Task Force suggests that behavioral counseling can increase sun protective behaviors, particularly among persons aged 10-24 years. Additionally, environmental and policy changes (for example, the provision of shade and sunscreen in recreational setting) could be promising strategies for creating social and physical environments that routinely promote sun protection for younger adults and persons of all ages" (Ann. Intern. Med. 2012 May 8 [Epub ahead of print]).
The indoor tanning study used NHIS data from 2010 and included information from 25,233 respondents aged 18 years and older.
Overall, 6% of respondents reported indoor tanning in the past 12 months, reported Ms. Hartman. Tanning was most common among young adults, with 12% of those aged 18-25 years and 9% of those aged 26-29 years using it.
A total of 9% of those with a family history of skin cancer reported indoor tanning, as did 8% of those who had a sunburn within the past 12 months. The associations with cancer and sunburn suggest that many people still don’t understand the dangers of indoor tanning, Ms. Hartman said.
Tanning was also related to socioeconomic status; 7% of those with some college or technical school and 7% of those with an income of more than 200% of the federal poverty level reporting indoor tanning.
The highest rates were in white women aged 18-21 years (32%), particularly those from the Midwest (44%). A total of 36% of Southern women aged 22-25 years also reported indoor tanning.