Cutaneous Melanoma: Sun Protection Behaviors and UV Exposure in Canada

In Canada, cutaneous melanoma is the eighth most common cancer, with more than 11,000 cases projected in 2024. To better understand the rising incidence of cutaneous melanoma in Canada, researchers conducted a study that highlights significant demographic and socioeconomic disparities in sun protection behavior and UV exposure across the country.

The results were published in BMJ Public Health.

The researchers sampled 77,209 individuals aged 18 years or older using data from the Canadian Community Health Survey (CCHS), which includes an optional sun safety component, between 2011 and 2018. The analysis participants were not living with cancer at the time of response.

Sun Exposure

According to the analysis, 75.5% of the respondents spent at least 30 minutes in the sun during the summer, and 45.7% spent 2 or more hours in the sun. One-third (33.3%) reported having sunburn within 12 months of responding to the CCHS. Two-thirds (64.3%) reported using sunscreen sometimes, rarely, or never on the body; 58.1% used sunscreen sometimes, rarely, or never on the face.

Age

Time spent in the sun was inversely proportional to age, with almost 60% of respondents aged 18 to 29 reporting spending 2 or more hours in the sun. Sunburn incidence decreased with age, with respondents aged 70 years or older having 90% lower odds of sunburn compared with respondents aged 18 to 29 years (odds ratio [OR], 0.10; 95% CI, 0.06-0.11).

Sunscreen use on the body varied by age group. Individuals aged 30 to 59 were significantly more likely to apply sunscreen to both the face and body compared with those aged 18 to 29. Adults aged 70 and older were significantly less likely to use sunscreen on the face (OR, 0.70, 95% CI 0.61-0.79) and body (OR, 0.52, 95% CI 0.46-0.59) than individuals aged 18 to 29.

Sex

Compared with men, women were significantly less likely to spend 2 or more hours in the sun (OR, 0.69; 95% CI 0.62-0.76). Women had 185% higher odds of using sunscreen on the body (OR, 2.85; 95% CI, 2.68-3.03) and 322% higher odds of using it on the face (OR, 4.22; 95% CI, 3.96-4.49) compared with men. Women also had a lower likelihood of sunburn (OR, 0.85; 95% CI, 0.80-0.90).

The researchers observed a significant upward trend over time in the proportion of men and women spending 2 or more hours in the sun (P=0.0018 and P=0.0023, respectively). Among men, there was a decline in sunburn prevalence (P=0.31), and no trend was detected among women (P=0.98). Sunscreen use on the body showed a decreasing trend for both men (P=0.10) and women (P=0.01), as did facial sunscreen use (P=0.027 for men and P=0.0064 for women).

Income

Time spent in the sun increased with income level: 34.7% of individuals in the lowest income quintile (quintile 1) reported spending 2 or more hours in the sun, compared with 56.8% in the highest quintile (quintile 5). Sunburn incidence also increased with income, with individuals in the highest quintile having significantly higher odds of sunburn in the previous 12 months (OR, 1.66; 95% CI, 1.46-1.87). Those in the highest income group had 78% higher odds of using sunscreen on the body (OR, 1.78; 95% CI 1.55-2.04) and 145% higher odds of applying it to the face (OR, 2.45; 95% CI 2.10-2.86) than those in the lowest income group.

“Despite increased awareness of melanoma risks, trends indicate a troubling rise in sun exposure over the years, coupled with inconsistent sunscreen use. These findings underscore the urgent need for targeted public health interventions and policies to promote effective sun safety behaviours, particularly among high-risk populations,” the researchers concluded.

Reference

Moustaquim-Barrette A, et al. BMJ Pub Health. 2025;3(1):e001983. doi:10.1136/bmjph-2024-001983