Even though people may be more careful in the sun after developing skin cancer, having had a malignancy still doesn’t persuade everybody to take such basic precautions as wearing hats or sunscreen, a study suggests.

Researchers analyzed survey data from about 760 adults with a history of skin cancer and more than 34,000 people without prior malignancies.

People with a skin cancer history were more than twice as likely to wear sunscreen and more than 50 percent as likely to wear hats and long sleeves than individuals who didn’t have a history of these tumors, the study found.

But past skin cancer wasn’t tied to lower odds of sunburns, even after accounting for the fact that some people are more susceptible to sunburn than others, said the study’s lead author, Alexander Fischer of the Johns Hopkins University School of Medicine.

“We were surprised to see that,” Fischer said by email. “This population is already at high risk for developing a subsequent skin cancer.”


One in 5 Americans will develop skin cancer, and one person in the United States dies from melanoma every hour, according to the American Academy of Dermatology.

To assess how a history of skin cancer influences behavior in the sun, Fischer and colleagues focused on what’s known as non-melanoma skin cancers, the most common type. Most of these malignancies are basal cell carcinoma, which can damage deeper tissues such as muscle and bone but generally doesn’t spread to other parts of the body.

Forty-four percent of people with a history of these tumors said they frequently sought out shade outdoors, compared with 27 percent of individuals who had no such history, researchers report in the Journal of the American Academy of Dermatology.

About 26 percent of people with a history of skin cancer wore wide-brimmed hats and roughly 21 percent donned long sleeves, compared with 11 percent and 8 percent, respectively, for people without a history of these tumors.

Even with a history of skin cancer, though, only 54 percent of people used sunscreen. That’s better than just 33 percent among people without such a history, but it still leaves a lot of people unprotected from sun damage.

Part of the problem may be that most sunburns aren’t the result of people deliberately sitting out in the sun all day to get a tan, said David Leffell, chief of skin cancer and dermatologic surgery at Yale School of Medicine, who wasn’t involved in the study.

“Most sunburns in patients who have had skin cancer are not the result of intentional sunning — as on the beach, etc. — but from moments of inattention, or unexpected such as on the playing field, walking outdoors, etc.,” Leffell said by email.