Barriers to Sun Safety: Clinic Study on High-Risk Habits
Even among individuals visiting dedicated skin cancer clinics, adopting regular protective measures is not universal. Research published in The Australasian journal of dermatology investigated how specific background factors, personal risk levels, and perceptions influence preventive actions. Reviewing these findings helps clarify why certain groups skip protective measures and where educational efforts need to improve.
Study Design and Patient Population
The research was conducted as a cross-sectional analysis using questionnaire data collected between February 2021 and September 2023. Investigators surveyed participants attending dermatology clinics across two major melanoma centres located in Sydney, Australia. In total, data from 883 people were analysed.
Because the investigation took place strictly within specialised Australian centres, it provides direct insight into patients already connected to specialty dermatologic care. However, as an observational cross-sectional study, it captures behaviors and personal traits at a single point in time, meaning it identifies associations rather than direct cause-and-effect relationships.
Measuring Daily Habits: The SPH Index
To evaluate patient actions, researchers utilized the Sun Protection Habits (SPH) index as their primary outcome. This index was analyzed as a continuous summary score based on questionnaire responses rated on a Likert scale. The survey captured habitual practices carried out over the previous month, examining how people handle physical coverage and outdoor timing.
The SPH index specifically measured several distinct protective components, including:
- Habitual use of sunscreen
- Wearing hats
- Wearing sunglasses
- Wearing a shirt with sleeves that covers the shoulders
- Limiting midday sun exposure
- Seeking shade
Understanding these distinct physical defenses is essential for comprehensive coverage, as outlined in our guide on sun protection beyond sunscreen.
Factors Linked to Less Frequent Sun Protection
The primary analysis from the Australasian journal of dermatology study revealed distinct demographic and clinical traits tied to lower overall scores on the SPH index. People who engaged in less frequent sun protection behaviors overall shared several identifiable characteristics:
- Male gender
- No personal history of melanoma
- Lower perceived risk of skin cancer
- Lower calculated 10-year risk of developing melanoma
- No private health insurance
The link between lower perceived threat and reduced precaution shows that personal risk perception strongly tracks with daily habits. When individuals underestimate their vulnerability or lack a formal previous diagnosis, they appear significantly less inclined to maintain routine photoprotection.
Age-Specific Divergence in Protective Methods
When examining how individual components of the SPH index were used across generations, researchers observed a clear generational split. People aged over 61 years reported lower use of sunscreen compared with individuals in the younger age group.
However, this older demographic did not abandon defense entirely. Instead, people aged over 61 years demonstrated a higher use of hats and sleeved shirts covering their shoulders relative to younger participants. This suggests that older individuals may favor physical garments and broad-brimmed coverings over topical lotions, whereas younger patients tend to rely more heavily on sunscreen bottles while foregoing protective clothing.
Areas Where Behaviors Showed No Differences
Interestingly, the investigation demonstrated that several common variables had no measurable association with overall protection scores. There was no difference in overall sun protection behaviors based on:
- Family history of melanoma
- Country of birth
- Lifetime melanoma risk among people without a personal history of melanoma
Even though having relatives with skin cancer or having higher lifetime objective risk models might be expected to spur vigilance, the data indicated that these factors alone did not translate into higher SPH scores among those who had not personally experienced a diagnosis. More details on clinical risk evaluations can be found in our overview of how doctors assess skin cancer risk.
Study Limitations and Doctor-Led Education
As noted in the publication record on PubMed (PMID 38845454), these results should not be overstated beyond the context of the study. Because the findings rely on self-reported questionnaire data over the past month, recall bias remains a natural limitation. Furthermore, because it took place solely within two specialist clinics in Sydney, findings may not fully match the behaviors of the wider public or individuals in non-specialist care settings.
Nonetheless, the authors concluded that these findings highlight clear opportunities for targeted patient education and public health messaging. By directing tailored guidance toward high-risk individuals—particularly men, individuals lacking a personal diagnosis, and those underestimating their 10-year risk—dermatologists and medical providers can more effectively close the gap in everyday prevention habits.
Sources
Published October 30, 2026. Sources are linked in the text. See our Medical Disclaimer.