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Sun Protection Behavior Following Skin Cancer Resection and Reconstruction

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Abstract

Increased exposure to ultraviolet radiation (UVR) is associated with an increased risk of nonmelanoma skin cancer. Cutaneous surgery can be negatively influenced by UVR, causing delayed wound healing, hyperpigmentation of the scar, and an increased incidence of additional skin cancers. By changing sun protection behavior, these risks can be limited. Therefore, this study evaluates changes in patients’ sun protective behavior after Mohs micrographic surgery (MMS). Patients undergoing MMS between December 2017 and November 2019 were included. Patients were asked to complete the FACE-Q Skin Cancer - Sun Protection Behavior checklist before and 3 months and 1 year post-surgery. A total of 125 patients completed the pre-operative and 3-months post-operative checklists, and 89 (71.2%) completed the 1-year post-operative checklist. Reported sun protective behaviors increased post-surgery at all time points (p < 0.001). Patients with a prior history of facial skin cancer demonstrated a larger increase in sun protection behaviors after surgery than patients without a history of facial skin cancer (p = 0.04). Patients with defects located on the ear or scalp demonstrated a lesser increase in sun protection behaviors than patients with defects located in more conspicuous areas as the face (p = 0.02). Our study demonstrates a change in sun protection behavior, with an increase in sun protection behavior over time in patients after MMS. However, more improvement is possible. Targeted counseling can increase sun protection behavior in patients without a history of facial skin cancer and patients with skin cancer located on the ears or scalp.

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Funding

Andrea Pusic is co-developer of the FACE-Q Skin Cancer which is owned by Memorial Sloan Kettering Cancer Center.

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Catharina Hospital, Eindhoven, the Netherlands

    I. J. Veldhuizen, E. Schroen & M. M. Hoogbergen

  2. Dermatology Division, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    I. J. Veldhuizen, E. H. Lee, N. R. Kurtansky & S. W. Dusza

  3. Department of Plastic and Reconstructive Surgery, Nutrim, Maastricht University Medical Center, Maastricht, the Netherlands

    I. J. Veldhuizen & R. R. W. J. van der Hulst

  4. Plastic and Reconstructive Surgery Division, Brigham and Women’s Hospital, Boston, MA, USA

    A. L. Pusic

Authors
  1. I. J. Veldhuizen
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  2. E. Schroen
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  3. E. H. Lee
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  4. N. R. Kurtansky
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  5. S. W. Dusza
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  6. R. R. W. J. van der Hulst
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  7. A. L. Pusic
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  8. M. M. Hoogbergen
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Contributions

Dr. Inge J. Veldhuizen and Dr. Maarten M. Hoogbergen had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. All authors read and approved the final manuscript.

1. Study concept and design: Veldhuizen, Lee, Hoogbergen, Kurtansky, Schroen, Hulst

2. Acquisition, analysis, and interpretation of data: Veldhuizen, Schroen, Lee, Dusza, Kurtansky, Hulst, Pusic, Hoogbergen

3. Drafting of the manuscript: Veldhuizen, Schroen

4. Critical revision of the manuscript for important intellectual content: Veldhuizen, Schroen, Lee, Kurtansky, Dusza, Hulst, Pusic, Hoogbergen

5. Statistical analysis: Dusza, Kurtansky, Veldhuizen

6. Administrative, technical, or material support: Veldhuizen, Lee, Schroen, Hulst, Pusic, Hoogbergen

7. Study supervision: Hoogbergen

Corresponding author

Correspondence to M. M. Hoogbergen.

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Veldhuizen, I.J., Schroen, E., Lee, E.H. et al. Sun Protection Behavior Following Skin Cancer Resection and Reconstruction. J Canc Educ 37, 1401–1406 (2022). https://doi.org/10.1007/s13187-021-01971-x

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