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Introduction
Avoiding sunburns and intermittent high-intensity sun exposure (especially in children, teens, and young adults) reduces the chances of getting melanoma skin cancer. Engaging in sun protective behaviors when outside can reduce one’s exposure to UV radiation and sunburn. For example, broad spectrum sunscreen (protects against UVA and UVB) should be used and applied appropriately (e.g., proper amount applied, sunscreens should be applied prior to exposure, and sunscreen should be reapplied for prolonged UV exposure). In recent years, the Food and Drug Administration has improved standards for sunscreen content and labeling. Seeking shade can also reduce the risk of sunburn and one of the goals of the Surgeon General’s Call To Action to Prevent Skin Cancer is to increase the availability of shade in outdoor recreation, education, and workplace environments.
Addition behaviors such as wearing sunglasses and sun protective clothing (e.g., long sleeve shirt, long pants, and wide brim hat) can help prevent excessive exposure to UV. Sun protective behaviors are most needed when UV intensity is greatest, which occurs during the summer time and between 10 am and 4 pm. However, for some regions of the US, such as the southeast and southwest, UV intensity is high year round. To help maximize one’s protection, multiple sun protective behaviors should be practiced.
Measure
The percentage of adults aged 18 years and older who reported that they usually or always practice at least one of three sun-protective behaviors - using sunscreen, wearing protective clothing (a long-sleeve shirt, and/or wide brimmed hat shading the face, ears, and neck, and/or long pants/long skirt), or seeking shade when going outside on a sunny day for more than an hour.
Beginning in 2005, the question on hat use (as part of protective clothing) was modified to more accurately distinguish baseball caps (which do not fully protect the face, neck, and ears) from other types of fully protective hats. Graphic illustrations of different hats were used, and respondents were asked a separate question about baseball cap and sun visor use. Also, long pants/long skirt was an item added in 2005.
The data series for this measure page have differing years of availability with 'protective clothing' available for 2005+, 'sunscreen use (SPF 15+)' available for 2000+ and 'likely to seek shade' available for 1992+. For the graphs that compare the different methods or present a total of all three protection types, trends were calculated for 2005+. For graphs that show the series individually, the full range of available data is shown.
Healthy People 2020 Target
- Increase to 11.2 percent the proportion of adolescents in grades 9 through 12 who follow protective measures that may reduce the risk of skin cancer.
- Increase to 73.7 percent the proportion of adults aged 18 years and older who follow protective measures that may reduce the risk of skin cancer.
Healthy People 2020 is a set of goals set forth by the Department of Health and Human Services.
Note: Goals are indicated as blue line on Detailed Trend Graphs.
Data Source
Centers for Disease Control and Prevention, National Center for Health Statistics. National Health Interview Survey NCI and CDC co-sponsored Cancer Control Supplement, 1992-2010, 2005–2015.
Trends and Most Recent Estimates
Sun Protection Methods
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
Total![]() |
70.8 | 69.9 - 71.6 |
Sunscreen (SPF 15+)![]() |
33.7 | 32.8 - 34.5 | |
Protective clothing![]() |
38.4 | 37.6 - 39.2 | |
Seek Shade![]() |
39.1 | 38.3 - 40.0 |
Use Some Type of Protection
By Sex
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
Both Sexes![]() |
70.8 | 69.9 - 71.6 |
Male![]() |
66.7 | 65.6 - 67.8 | |
Female![]() |
74.8 | 73.8 - 75.7 |
By Race/Ethnicity
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
All Races![]() |
70.8 | 69.9 - 71.6 |
Non-Hispanic White![]() |
69.6 | 68.6 - 70.7 | |
Non-Hispanic Black![]() |
67.7 | 65.5 - 69.9 | |
Hispanic![]() |
75.7 | 74.0 - 77.3 |
By Age
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
Ages 18-24![]() |
60.6 | 57.8 - 63.5 |
Ages 25+![]() |
72.3 | 71.4 - 73.1 |
By Sex and Age
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
Males, Ages 18-24![]() |
55.4 | 51.5 - 59.2 |
Males, Ages 25+![]() |
68.3 | 67.2 - 69.5 | |
Females, Ages 18-24![]() |
66.2 | 62.5 - 69.6 | |
Females, Ages 25+![]() |
76.0 | 75.0 - 77.0 |
By Poverty Income Level
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
<200% of federal poverty level![]() |
71.5 | 70.3 - 72.7 |
>=200% of federal poverty level![]() |
70.5 | 69.4 - 71.5 |
By Education Level
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
Less than High School![]() |
73.6 | 71.5 - 75.5 |
High School![]() |
69.3 | 67.8 - 70.9 | |
Greater than High School![]() |
72.9 | 71.9 - 73.9 |
Use Sunscreen
By Sex
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
Both Sexes![]() |
33.7 | 32.8 - 34.5 |
Male![]() |
23.4 | 22.4 - 24.4 | |
Female![]() |
43.6 | 42.4 - 44.8 |
By Race/Ethnicity
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
All Races![]() |
33.7 | 32.8 - 34.5 |
Non-Hispanic White![]() |
40.4 | 39.3 - 41.5 | |
Non-Hispanic Black![]() |
10.9 | 9.8 - 12.2 | |
Hispanic![]() |
24.7 | 23.1 - 26.4 |
By Age
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
Ages 18-24![]() |
25.9 | 23.2 - 28.9 |
Ages 25+![]() |
34.8 | 33.9 - 35.7 |
By Sex and Age
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
Males, Ages 18-24![]() |
17.0 | 14.1 - 20.4 |
Males, Ages 25+![]() |
24.3 | 23.2 - 25.5 | |
Females, Ages 18-24![]() |
35.3 | 31.4 - 39.3 | |
Females, Ages 25+![]() |
44.8 | 43.6 - 46.0 |
By Poverty Income Level
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
<200% of federal poverty level![]() |
21.4 | 20.3 - 22.6 |
>=200% of federal poverty level![]() |
38.7 | 37.6 - 39.7 |
By Education Level
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
Less than High School![]() |
16.0 | 14.2 - 18.0 |
High School![]() |
24.9 | 23.4 - 26.5 | |
Greater than High School![]() |
41.8 | 40.7 - 43.0 |
Wear Protective Clothing
By Sex
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
Both Sexes![]() |
38.4 | 37.6 - 39.2 |
Male![]() |
43.6 | 42.4 - 44.8 | |
Female![]() |
33.4 | 32.4 - 34.4 |
By Race/Ethnicity
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
All Races![]() |
38.4 | 37.6 - 39.2 |
Non-Hispanic White![]() |
34.7 | 33.6 - 35.7 | |
Non-Hispanic Black![]() |
39.6 | 37.4 - 41.7 | |
Hispanic![]() |
49.0 | 47.2 - 50.9 |
By Age
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
Ages 18-24![]() |
27.1 | 24.6 - 29.7 |
Ages 25+![]() |
40.1 | 39.2 - 41.0 |
By Sex and Age
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
Males, Ages 18-24![]() |
31.8 | 28.1 - 35.7 |
Males, Ages 25+![]() |
45.3 | 44.0 - 46.6 | |
Females, Ages 18-24![]() |
22.1 | 19.1 - 25.5 | |
Females, Ages 25+![]() |
35.0 | 34.0 - 36.2 |
By Poverty Income Level
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
<200% of federal poverty level![]() |
43.4 | 42.0 - 44.8 |
>=200% of federal poverty level![]() |
36.2 | 35.2 - 37.2 |
By Education Level
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
Less than High School![]() |
51.7 | 49.3 - 54.1 |
High School![]() |
40.8 | 39.1 - 42.6 | |
Greater than High School![]() |
37.7 | 36.6 - 38.8 |
Seek Shade
By Sex
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
Both Sexes![]() |
39.1 | 38.3 - 40.0 |
Male![]() |
31.9 | 30.8 - 33.2 | |
Female![]() |
46.0 | 45.0 - 47.1 |
By Race/Ethnicity
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
All Races![]() |
39.1 | 38.3 - 40.0 |
Non-Hispanic White![]() |
34.1 | 33.1 - 35.1 | |
Non-Hispanic Black![]() |
48.7 | 46.5 - 50.9 | |
Hispanic![]() |
49.1 | 47.2 - 50.9 |
By Age
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
Ages 18-24![]() |
32.0 | 29.5 - 34.6 |
Ages 25+![]() |
40.2 | 39.3 - 41.1 |
By Sex and Age
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
Males, Ages 18-24![]() |
25.5 | 22.4 - 28.9 |
Males, Ages 25+![]() |
32.9 | 31.6 - 34.2 | |
Females, Ages 18-24![]() |
38.8 | 35.3 - 42.4 | |
Females, Ages 25+![]() |
47.1 | 46.1 - 48.1 |
By Poverty Income Level
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
<200% of federal poverty level![]() |
45.6 | 44.3 - 47.0 |
>=200% of federal poverty level![]() |
36.3 | 35.3 - 37.4 |
By Education Level
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
---|---|---|---|
Percent of adults | 95% Confidence Interval | ||
![]() ![]() |
Less than High School![]() |
46.0 | 43.6 - 48.4 |
High School![]() |
39.9 | 38.0 - 41.7 | |
Greater than High School![]() |
39.0 | 37.9 - 40.1 |
Evidence-based Resources
Resources are available on sun-protective behaviors that are effective at lowering risk of skin cancer. Visit the sun safety on Cancer Control P.L.A.N.E.T. web portal. Multicomponent community-wide interventions are recommended to prevent skin cancer as well as education and policy approaches.
Additional Information on UV Exposure and Sun Protective Practices
For the public
- Skin Cancer. American Cancer Society.
- Skin Cancer. National Cancer Institute.
- Indoor Tanning Restrictions for Minors – A State-by-State Comparison (May 2017). National Conference of State Legislatures.
- National Council on Skin Cancer Prevention.
- Sunscreen drug products for over-the-counter human use, 2011. U.S. Food and Drug Administration.
- Sunburn protection factor (SPF). U.S. Food and Drug Administration.
For health professionals
- Vitamin D and Calcium: A Systematic Review of Health Outcomes (Update). AHRQ Publication No. 14-E004-EF September 2014. Evidence Report/Technology Assessment Number 217.
- Preventing skin cancer: multicomponent community-wide interventions (abbreviated). Community Preventive Services Task Force.
- Indoor Tanning Association settles FTC charge that it deceived customers about skin cancer risks from tanning. Federal Trade Commission.
- Melanoma Treatment (PDQ®). National Cancer Institute.
- Skin Cancer Treatment (PDQ®). National Cancer Institute.
- Stratosphere: UV index. National Weather Service: Climate Prediction Center.
- Sun Safety. U.S. Environmental Protection Agency.
- Sunlamp products and ultraviolet lamps intended for use in sunlamp products. U.S. Food and Drug Administration. Title 21. Food and drugs. CFR 1040.20. Fed Regist. 2017.
- Sunlamps and Sunlamp Products (Tanning Beds/Booths). U.S. Food and Drug Administration.
- General and plastic surgery devices: reclassification of ultraviolet lamps for tanning, henceforth to be known as sunlamp products and ultraviolet lamps intended for use in sunlamp products. U.S. Food and Drug Administration. Rule. Fed Regist. 2014;79:31205-31214.
- Skin Cancer: Counseling. U.S. Preventive Services Task Force.
Scientific reports
- Surgeon General Call to Action to Prevent Skin Cancer, 2014.
- Indoor tanning: The risks of ultraviolet rays. U.S. Food and Drug Administration.
- Buying indoor tanning with university debit cards. Boyers L, Karimkhani C, Crane LA, Asdigian N, Hollonds A, Dellavalle RP. J Am Acad Dermatol. 2014;71(1):199-201.
- VITamin D and OmegA-3 TriaL (VITAL Study). Brigham and Women’s Hospital.
- Prevalence of sunburn, sun protection, and indoor tanning behaviors among Americans: review from national surveys and case studies of 3 states. Buller DB, Cokkinides V, Hall HI, et al. J Am Acad Dermatol. 2011;65(5):S114–S123.
- User-centered development of a smart phone mobile application delivering personalized real-time advice on sun protection. Buller DB, Berwick M, Shane J, Kane I, Lantz K, Buller MK. Transl Behav Med. 2013;3(3):326-334.
- Sunburn and sun protective behaviors among adults aged 18–29 Years – United States, 2000–2010. Centers for Disease Control and Prevention. MMWR 2012;61(18);317–322.
- Use of indoor tanning devices by adults – United States, 2010. Centers for Disease Control and Prevention. MMWR 2012;61(18);323–326.
- Reduced melanoma after regular sunscreen use: randomized trial follow-up. Green A, Williams GM, Logan V, and Strutton GM. J Clin Oncol. 2011;29(3):257–263.
- State indoor tanning laws and adolescent indoor tanning. Guy GP, Berkowitz Z, Jones SE, et al. Am J Public Health. 2014;104(4):e69-e74.
- The association between demographic and behavioral characteristics and sunburn among U.S. Adults – National Health Interview Survey, 2010. Holman DM, Berkowitz Z, Guy GP, Hartman AM, Perna FM. Prev Med. 2014;63:6-12.
- Correlates of intentional tanning among adolescents in the United States: a systematic review of the literature. Holman DM, Watson M. J Adolesc Health. 2013;52(5 suppl):S52-S59.
- History and culture of tanning in the United States. Hunt Y, Auguston E, Rutten L, Moser R. In: Heckman CJ, Manne EL, eds. Shedding Light on Indoor Tanning. New York, NY: Springer; 2012:5-30.
- Solar and ultraviolet radiation. International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans 2012;100D:36–102.
- Indoor tanning and risk of melanoma: a case-control study in a highly exposed population. Lazovich D, Vogel R, Berwick M, et al. Cancer Epidemiol Biomarkers Prev 2010;19(6):1557–68.
- Adverse effects of ultraviolet radiation from the use of indoor tanning equipment: time to ban the tan. Lim HW, James WD, Rigel DS, et al. J Am Acad Dermatol. 2011;64(4):e51–60.
- Behavioral counseling to prevent skin cancer: a systematic review for the U.S. Preventive Service Task Force. Lin JS, Eder M, Weinmann S. Ann Intern Med. 2011;154:190–201.
- Adolescents’ use of indoor tanning: a large-scale evaluation of psychosocial, environmental, and policy- level correlates. Mayer JA, Woodruff SI, Slymen DJ, et al. Am J Public Health. 2011;101(5):930-938.
- Behavioral counseling to prevent skin cancer: U.S. Preventive Services Task Force recommendation statement. Moyer VA, U.S. Preventive Services Task Force. Ann Intern Med. 2012;157(1):59-65.
- Reducing environmental cancer risk: what we can do now. National Cancer Institute. 2008–2009 Annual Report of the President’s Cancer Panel.
- Subsequent primary malignancies in patients with nonmelanoma skin cancer in England: a national record-linkage study. Ong EL, Goldacre R, Hoang U, Sinclair R, Goldacre M. Cancer Epidemiol Biomarkers Prev. 2014;23(3):490-498.
- Increasing incidence of melanoma among young adults: an epidemiological study in Olmsted County, Minnesota. Reed KB, Brewer JD, Lohse CM, et al. Mayo Clin Proc. 2012;87(4):328–334.
- Implications of lessons learned from tobacco control for tanning bed reform. Sinclair C, Makin JK. Prev Chronic Dis. 2013;10:e28.
Statistics
- SEER Cancer Statistics Review, National Cancer Institute.