Journal of Behavioral Medicine

, Volume 18, Issue 5, pp 461–477 | Cite as

Predictors of gender differences in sunscreen use and screening outcome among skin cancer screening participants

  • Laurel Lockwood Hourani
  • Bonnie LaFleur


This study identified predictors of sunscreen use in males and females and examined the extent to which gender differences in sunscreen use were associated with skin cancer screening outcomes. Subjects were 351 adult Southern California residents who participated in one of five free skin cancer screenings. Logistic regression models showed that sunscreen use was significantly associated with sex, personal and family history of skin cancer, and a sun sensitivity index. The latter three factors were found to be confounders of the sex-sunscreen use relationship. Whereas female use of sunscreen was best predicted by her sun sensitivity, male use of sunscreen was best predicted by a family history of skin cancer. Screening outcomes also varied by sex, suggesting that the interrelationships among gender, family history of skin cancer, and sun sensitivity have important implications for sunscreen use, which may in turn impact clinical outcomes.

Key Words

skin cancer sunscreen cancer screening gender 


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  1. Bandura, A. (1989). Human agency in social cognitive theory.Am. Psychol. 44: 1175–1184.Google Scholar
  2. Berwick, M., Fine, J. A., and Bolognia, J. L. (1992). Sun exposure and sunscreen use following a community skin cancer screening.Prev. Med. 21: 302–310.Google Scholar
  3. Biddle, S., Goudas, M., and Page, A. (1994). Social-psychological predictors of self-reported actual and intended physical activity in a university workforce sample.Br. J. Sp. Med. 28: 160–163.Google Scholar
  4. Cody, R., and Lee, C. (1990). Behaviors, beliefs, and intentions in skin cancer prevention.J. Behav. Med. 13: 373–389.Google Scholar
  5. Department of Community and Environmental Medicine, University of California at Irvine (1986).Cancer Surveillance Program of Orange County: Results—1984. Author, Irvine, CA.Google Scholar
  6. Garland, C. F., Garland, F. C., and Gorham, E. D. (1992). Could sunscreens increase melanoma risk?AJPH 82: 614–615.Google Scholar
  7. Garland, C. F., Garland, F. C., and Gorham, E. D. (1994). Re: Effect of sunscreens on UV radiation-induced enhancement of melanoma growth in mice.J. Natl. Cancer Inst. 86: 798.Google Scholar
  8. Graham, S., Marshall, J., Haughey, B., Stoll, H., Zielesny, M., Brasure, J., and West, D. (1985). An inquiry into the epidemiology of melanoma.Am. J. Epidemiol. 122: 606–619.Google Scholar
  9. Holman, C. D., and Armstrong, B. K. (1984). Pigmentary traits, ethnic origin, benign nevi, and family history as risk factors for cutaneous malignant melanoma.J. Natl. Cancer Inst. 72: 257–266.Google Scholar
  10. Holman, C. D., Evans, P. R., Lumsden, G. J., and Armstrong B. K. (1984). The determinants of actinic skin damage: Problems of confounding among environmental and constitutional variables.Am. J. Epidemiol. 120: 414–422.Google Scholar
  11. Holman, C. D., Armstrong, B. K., and Heenan, P. T. (1986). Relationship of cutaneous malignant melanoma to individual sunlight-exposure habits.J. Natl. Cancer Inst. 76: 403–414.Google Scholar
  12. Hosmer, D. W., and Lemeshow, S. (1989).Applied Logistic Regression, John Wiley & Sons, New York.Google Scholar
  13. Hunter, D. J., Colditz, G. A., Stampfer, M. J., Rosner, B., Willett, W. C., and Speizer, F. E. (1990). Risk factors for basal cell carcinoma in a prospective cohort of women.Ann. Epidemiol. 1: 13–23.Google Scholar
  14. Janz, N. K., and Becker, M. H. (1984). The health belief model: A decade later.Health Educ. Q. 11: 1–47.Google Scholar
  15. Johnson, E. Y., and Lookingbill, D. P. (1984). Sunscreen use and sun exposure.Arch. Dermatol. 120: 727–731.Google Scholar
  16. Jones, J. L., and Leary, M. R. (1994). Effects of appearance-based admonitions against sun exposure on tanning intentions in young adults.Health Psychol. 13: 86–90.Google Scholar
  17. Keesling, B., and Friedman, H. S. (1987). Psychosocial factors in sunbathing and sunscreen use.Health Psychol. 6: 477–493.Google Scholar
  18. Koh, H. K., and Lew, R. A. (1994). Sunscreens and melanoma: Implications for prevention.J. Natl. Cancer Inst. 86: 78–79.Google Scholar
  19. Leary, M. R., and Jones, J. L. (1993). The social psychology of tanning and sunscreen use: Self-presentational motives as a predictor of health risk.J. Appl. Soc. Psychol. 23: 1390–1406.Google Scholar
  20. Mullen, P. D., Hersey, J. C., and Iversen, D. C. (1987). Health behavior models compared.Soc. Sci. Med. 24: 973–981.Google Scholar
  21. O'Doherty, C. J., Prescott, R. J., White, H., McIntyre, M., and Hunter, J. A. (1986). Sex differences in presentation of cutaneous malignant melanoma and in survival from stage I disease.Cancer 58: 788–792.Google Scholar
  22. Pathak, M. A. (1987). Sunscreens and their use in the preventive treatment of sunlight-induced skin damage.J. Dermatol. Surg. Oncol. 13: 739–750.Google Scholar
  23. Rampen, F. H. (1984). Sex differences in survival from cutaneous melanoma.Int. J. Dermatol. 23: 444–452.Google Scholar
  24. Ronis, D. L. (1992). Conditional health threats: Health beliefs, decisions, and behaviors among adults.Health Psychol. 11: 127–134.Google Scholar
  25. Skolnick, A. (1991). Sunscreen protection controversy heats up.JAMA 265: 3218–3220.Google Scholar
  26. Spilman, M. A. (1988). Gender differences in worksite health promotion activities.Soc. Sci. Med. 26: 525–535.Google Scholar
  27. Thompson, S. C., Jolley, D., and Marks, R. (1993). Reduction of solar keratoses by regular sunscreen use.N. Engl. J. Med. 329: 1147–1151.Google Scholar
  28. Thorn, M., Ponten, F., Bergstrom, R., Spaten, P., and Adami, H. (1994). Clinical and histopathologic predictors of survival in patients with malignant melanoma: A population-based study in Sweden.J. Natl. Cancer Inst. 86: 761–769.Google Scholar
  29. Verbugge, L. M. (1985). Gender and health: An update on hypotheses and evidence.J. Health Soc. Behav. 26: 156–182.Google Scholar
  30. Verbugge, L. M. (1989). The twain meet: Empirical explantation of sex differences in health and mortality.J. Health Soc. Behav. 30: 282–304.Google Scholar
  31. Weinstein, N. D. (1988). The precaution adoption process.Health Psychol. 7: 355–386.Google Scholar
  32. Weinstein, N. D. (1993). Testing four competing theories of health-protective behavior.Health Psychol. 12: 324–333.Google Scholar
  33. Wichstrom, I. (1994). Predictors of Norwegian adolescents' sunbathing and use of sunscreen.Health Psychol. 13: 412–420.Google Scholar
  34. Wolf, P., Donawho, C. K., and Kripke, M. L. (1994). Effect of sunscreens on UV radiation-induced enhancement of melanoma growth in mice.J. Natl. Cancer Inst. 186 99–105.Google Scholar

Copyright information

© Plenum Publishing Corporation 1995

Authors and Affiliations

  • Laurel Lockwood Hourani
    • 1
  • Bonnie LaFleur
    • 2
  1. 1.Clinical Cancer CenterUniversity of California Irvine Medical CenterUSA
  2. 2.Graduate School of Public Health, San Diego State UniversitySan DiegoUSA

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