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Physician, Slop Thyself

Study finds doctors don't protect themselves from the sun

TUESDAY, July 30, 2002 (HealthDayNews) -- You'd think, knowing what they know, that family doctors would never go out in the sun without sunscreen.

Think again. Physicians are no better than their patients at protecting themselves from sun exposure, a new study has found.

Researchers surveyed 84 physicians at a Rhode Island teaching hospital and 100 patients about their sun-protection habits. Researchers found doctors were slightly more likely to put on sunscreen if they were going to be in the sun for an hour or more.

About 42 percent of the physicians said they always or almost always wore sunscreen, compared to 28 percent of patients.

But on other measures, doctors did worse. About 29 percent of patients said they stayed in the shade to avoid sun exposure, compared to 17 percent of doctors. About 24 percent of patients said they wore a wide-brimmed hat to protect themselves, while just 17 percent of physicians did the same. And about 9 percent of patients reported they always or nearly always wore a long-sleeved shirt if they were going to be in the sun for an hour or more; only 1 percent of doctors did so.

Overall, doctors were no more likely than patients to use at least one form of sun protection.

"We really expected to see doctors outperform their patients in sun protection behaviors," says Chris Sciamanna, an assistant professor of community health at Brown University School of Medicine and lead author of the study. "We were really surprised to find they didn't."

The study appears in the July/August issue of the American Journal of Health Promotion.

Why does it matter what docs do? Research has shown doctors are more likely to counsel patients about good health practices if they practice those habits themselves. For instance, a previous study found doctors who eat a healthy diet are more likely to remind patients about the benefits of such a diet, Sciamanna said.

"If you depend on your doctor for good counseling about sun exposure, I don't know that that's going to happen," Sciamanna says. "A lot of them aren't doing it themselves, so they may not be the best messenger."

However, previous research has shown doctors do better than patients in other key health areas, including smoking. About 21 percent of adult Americans smoke, according to federal figures, compared to only 4 percent of doctors, according to a 1991 study in the Annals of Internal Medicine.

So why do they ignore their skin? When it comes to sun protection, doctors could be playing a numbers game, Sciamanna says.

Skin cancer is the most common of all cancers and accounts for about half of all cancer cases in the United States, according to the American Cancer Society. An estimated 51,400 people will be diagnosed with melanoma this year and about 1.3 million will be diagnosed with non-melanoma skin cancers.

But skin cancer is far from the most deadly cancer. About 7,800 people are expected to die of melanoma and about 2,000 people are expected to die of non-melanoma skin cancers this year.

While much still needs to be learned, research suggests adult sun exposure has little to do with melanoma, Sciamanna says.

Compare these rates to deaths from smoking. About 450,000 Americans die from smoking-related diseases each year, according to the American Cancer Society.

"Maybe doctors don't view skin cancer as that serious," Sciamanna says, adding that he is merely hypothesizing. "If the benefit of slapping on some sunscreen is to prevent 2,300 deaths among 280 million people, maybe it's not such a big deal."

Sciamanna believes it may be time to give doctors some counseling about their own health practices. "A lot of research has looked at changing doctors' counseling of patients, but very little has looked at changing doctors' personal behavior -- and maybe that has to happen," he says.

Those most at risk of skin cancer include people who have moles, fair skin, light hair, and burn before tanning, according to the American Cancer Society. Those who have had skin cancer before, or have a family history of the disease, need to use extra caution to protect themselves.

To reduce your risk of skin cancer, the American Cancer Society offers these tips:

  • Stay out of the sun as much as possible, especially between the hours of 10 a.m. and 4 p.m.;
  • Use sunscreen with SPF of 15 or higher;
  • Apply sunscreen at least 20 minutes before exposure;
  • Reapply sunscreen after swimming or sweating;
  • Cover up with a shirt and hat;
  • And avoid tanning salons or sunlamps.

What To Do

Read more about protecting your skin from the sun at the American Cancer Society, or the Skin Cancer Foundation.

SOURCES: Chris Sciamanna, Ph.D., M.P.H., assistant professor of community health, Brown University School of Medicine, Providence, R.I.; July/August 2002 American Journal of Health Promotion
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