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BACKGROUND. Sun exposure in childhood is an important risk factor for developing skin cancer as an adult. Despite extensive efforts to reduce sun exposure among the young, there are no population-based data on trends in sunburns and sun protection practices in the young. The aim of this study was to describe nationally representative trend data on sunburns, sun protection, and attitudes related to sun exposure among US youth. METHODS. Cross-sectional telephone surveys of youth aged 11 to 18 years in 1998 0N = 1196) and in 2004 (N = 1613) were conducted using a 2-stage sampling process to draw population-based samples. The surveys asked identical questions about sun protection, number of sunburns experienced, and attitudes toward sun exposure. Time trends were evaluated using pooled logistic regression analysis. RESULTS. In 2004, 69% of subjects reported having been sunburned during the summer, not significantly less than in 1998 (72%). There was a significant decrease in the percentage of those aged 11 to 15 years who reported sunburns and a nonsignificant increase among the 16- to 18-year-olds. The proportion of youth who reported regular sunscreen use increased significantly from 31% to 39%. Little change occurred in other recommended sun protection practices. CONCLUSIONS. A small reduction in sunburn frequency and modest increases in sun protection practices were observed among youth between 1998 and 2004, despite widespread sun protection campaigns. Nevertheless, the decrease in sunburns among younger teens may be cause for optimism regarding future trends. Overall, there was rather limited progress in improving sun protection practices and reducing sunburns among US youth between 1998 and 2004. www.pediatrics.org/cgi/doi/10.1542/ peds.2005-3109 doi:10.1542/peds.2005-3109 Key Words skin cancer, skin neoplasms prevention and control, sun exposure, sun protection, sunburn, sunscreen agents, adolescent, epidemiology, health surveys Abbreviations SPF 15+--sun protection factor [greater than or equal to] 15 CI--confidence interval, MORE THAN 1 million cases of basal cell or squamous cell carcinoma and 62 190 cases of invasive melanoma are expected in 2006 in the United States. (1) Of these, [...]

Objectives. We examined the prevalence of endoscopy (sigmoidoscopy or colonoscopy) by indication and by demographic and lifestyle factors. Methods. We analyzed cross-sectional data collected in 1997 from participants aged 50 years and older in the Cancer Prevention Study (CPS) II Nutrition Cohort. Results. Fifty-eight percent of men and 51% of women reported ever having undergone endoscopy; only 42% of men and 31% of women reported endoscopy for screening rather than for disease diagnosis or follow-up. Prevalence varied by demographic and lifestyle factors. Conclusions. Efforts to increase colorectal cancer screening need to target women, all persons aged 50-64 years, and those with colorectal cancer risk factors. Future studies should distinguish endoscopy for screening from procedures for disease diagnosis and follow-up to avoid overestimating screening compliance.

The authors obtained data from 335 breast cancer survivors and 6,880 noncancer controls. They proposed (1) to determine whether; after treatment, the survivors were meeting the Center for Disease Control and Prevention/American College of Sports Medicine recommendations for physical activity and were similar to the controls in physical activity and (2) to compare the modes of activity of the 2 groups in frequency, min/session, and sessions/wk. Adjusted logistic regression analyses revealed that the breast cancer survivors engaged in as much moderate, vigorous, and combined physical activity as the noncancer controls did. However, chi-square analyses showed that survivors engaged in more yard work than the controls did, whereas independent-sample t tests showed that the frequency and the total min/wk of stretching were significantly higher in breast cancer survivors compared with noncancer controls. Findings from the study suggest that breast cancer survivors engage in as much physical activity as controls do, but that the groups differ in specific activities. Index Terms: breast cancer survivors, noncancer controls, physical activity, treatment, Despite the positive physical, functional, and psychological (1-6) benefits that posttreatment breast cancer survivors (BCS) report when they engage in physical activity, uncertainty remains about how physically active these survivors [...]

Objective. Epidemiologic evidence suggests that ultraviolet radiation (UVR), from sun exposure and sunburns during early life, is associated with increased risk of melanoma and other skin cancers in adulthood. The objective of this study was to gather national, population-based data on sun exposure and protection behaviors among US youths ages 11 to 18 to quantify the magnitude and patterns of sun exposure and establish baselines for continued surveillance. Methods. A nationwide survey based on random-digit dialing and stratified, 2-stage national probability sampling was conducted of households with telephones in the 48 contiguous states of the United States during July through October of 1998; a population-based sample of 1192 youth ages 11 to 18 was studied to measure weighted prevalence estimates of summer sunburn and sun exposure and adjusted prevalence odds ratios and 95% confidence intervals from logistic regression analyses of sunburn. Results. Among youths ages 11 to 18, 72% reported having had at least 1 summer sunburn, 30% reported at least 3, and 12% reported at least 5 sunburns. Before receiving their most serious summer sunburn, 39% of youths reported having applied sunscreen. Factors associated with increased odds of sunburn included greater sun sensitivity, white race, age younger than 16 years, more hours spent outdoors, and high desirability of a tan. Conclusions. Summer sunburn was the norm among US youths ages 11 to 18. The high frequency of sunscreen use during the sunburning episodes suggests the need to educate youth and parents better about proper use of these agents, as well as the importance of practicing other sun protection behaviors, such as wearing hats and protective clothing and avoiding the sun during peak exposure times. These data may serve as a baseline for tracking progress in skin cancer prevention efforts and will inform the crafting of future public health campaigns. Pediatrics 2002;110:27-35; youth, skin cancer prevention, sunburn, behaviors, prevalence, national survey., Ultraviolet radiation (UVR) from sun exposure is the number 1 modifiable risk factor for skin cancer, including melanoma. The common nonmelanoma skin cancers are associated with exposure to UVR, (1,2) [...]

Background. Tanning parlors have become common in the United States. Artificial ultraviolet radiation exposure from this source may be harmful and may increase the risk of melanoma, particularly when done for recreational purposes during childhood and early adult years. Population-based data on the prevalence and correlates of this activity is important in the evaluation of potential public health interventions for skin cancer prevention. Study Design. In 1998, we conducted a population-based telephone survey of youth and their primary caregiver. The sample (N = 1192) was weighted to represent the population of US youth living in households with a primary caregiver. Interviewers used a standardized questionnaire to document the characteristics of the participant and their practices, attitudes, and experiences regarding ultraviolet exposures. Method of Analysis. Weighted prevalence and adjusted prevalence odds ratios (aPOR) and 95% confidence interval (95% CI) were estimated. Independent factors were evaluated with multivariate logistic regression. Results. Ten percent of youth and 8% of their primary caregivers used indoor tanning sunlamps in the previous year. Thirty percent of the youth whose caregivers used indoor tanning sunlamps did so themselves as well. Independent predictors associated with indoor tanning sunlamp use were as follows: age 17 to 18 years (aPOR = 11.1; 95% CI: 5.0, 25.0); female (aPOR = 8.3; 95% CI: 3.6, 19.2); having a parent who used indoor tanning sunlamps in the previous year (aPOR = 8.7; 95% CI: 4.0, 18.9); nonuser of Sun Protection Factor 15 sunscreen at the beach or pool (aPOR = 1.9; 95% CI: 1.0, 3.4); and low sun sensitivity (aPOR = 2.3; 95% CI: 1.0, 5.3). Conclusion. A substantial minority of American youth engages in indoor tanning. However, it is particularly prevalent among older youth, girls, and youth whose parents themselves use indoor tanning sunlamps. The knowledge of these trends may help focus public health initiatives. Pediatrics 2002;109:1124-1130; youth/ adolescents, skin cancer prevention, artificial ultraviolet radiation, surveillance epidemiology, health promotion/ prevention. ABBREVIATIONS. UV, ultraviolet; CI, confidence interval; POR, prevalence odds ratio; SPF, Sun Protection Factor; aPOR, adjusted prevalence odds ratio., Incidence rates in the United States of the 3 most prevalent forms of skin cancer associated with ultraviolet (UV) radiation exposure (ie, basal cell, squamous cell, and melanoma) have risen [...]