INTRODUCTION
Sun exposure is a risk factor for melanoma and non-melanoma skin cancer (NMSC),1,2 with NMSC being the cause of most skin cancer-related deaths.3 In addition, sun exposure contributes to photoaging, with changes in epidermal thickness, increased pigment heterogeneity, dermal elastosis, and degradation of dermis collagen.4,5
The most recent National Institutes of Health (NIH) data report a gradual increase in the use of sunscreen from 2000 to 2020 in adults. In 2020, 25% of males (up from 17.5% in 2000) and 47.5% of females (up from 35.5 in 2000) always, or most of the time, used SPF 15 or higher for sun protection.6 People under 25 years of age, those living in poverty, less educated people, and non-Hispanic Blacks were less likely to use sunscreen.6 Despite this gradual increase in sunscreen usage from 2000 to 2020, a study of sun-protective behaviors published in 2023 reported that young adults (under 40 years of age) are less likely to engage in sun-protective behaviors, such as wearing long-sleeved clothes.7 Moreover, a recent survey found Gen Z adults were less informed about protection from sun damage, with over half being sunburned in 2024.8
Studies have also revealed greater sun risk behaviors by rural vs urban residents, with some nuances by ethno-racial identity.9 A US cross-sectional follow-up survey of the Skin Health Study comparing urban and rural residents without a history of melanoma reported that rural participants were more likely to show suboptimal sunscreen behavior.10 A survey of skin cancer survivors found that around half infrequently wore protective clothing or sought shade, and one-third infrequently used sunscreen.11 Collectively, the data highlight significant disparities across age, gender, income, education, geography, and race.9-11
The most recent National Institutes of Health (NIH) data report a gradual increase in the use of sunscreen from 2000 to 2020 in adults. In 2020, 25% of males (up from 17.5% in 2000) and 47.5% of females (up from 35.5 in 2000) always, or most of the time, used SPF 15 or higher for sun protection.6 People under 25 years of age, those living in poverty, less educated people, and non-Hispanic Blacks were less likely to use sunscreen.6 Despite this gradual increase in sunscreen usage from 2000 to 2020, a study of sun-protective behaviors published in 2023 reported that young adults (under 40 years of age) are less likely to engage in sun-protective behaviors, such as wearing long-sleeved clothes.7 Moreover, a recent survey found Gen Z adults were less informed about protection from sun damage, with over half being sunburned in 2024.8
Studies have also revealed greater sun risk behaviors by rural vs urban residents, with some nuances by ethno-racial identity.9 A US cross-sectional follow-up survey of the Skin Health Study comparing urban and rural residents without a history of melanoma reported that rural participants were more likely to show suboptimal sunscreen behavior.10 A survey of skin cancer survivors found that around half infrequently wore protective clothing or sought shade, and one-third infrequently used sunscreen.11 Collectively, the data highlight significant disparities across age, gender, income, education, geography, and race.9-11
