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Attitudes toward sun exposure – and behaviors – change between childhood and adolescence, researchers have found, suggesting that children in this age bracket may be critical targets for physicians to advise.

Among children who were interviewed at age 10 years and again at 13, those in the elder group were only half as consistent in their sunscreen use as they had previously been, and were significantly more likely to report liking the appearance of a tan or seeking to become tan. Actual incidence of sunburn and tanning, meanwhile, remained high and largely unchanged between ages 10 and 13 years, with recent sunburns reported by more than half of children at both ages.

© Vesna Andjic/iStockphoto.com Despite the threat of damage to their skin, children increasingly prefer the appearance of a tan as they grow older.

The findings, published online Jan. 23 in Pediatrics, were the first to examine sunburn and sun behaviors prospectively in this age group.

Stephen W. Dusza, Dr.P.H., of Memorial Sloan-Kettering Cancer Center in New York, led SONIC (Study of Nevi in Children), which used self-reported data from 360 students who were enrolled as fifth graders in Framingham, Mass., schools in 2004 and had complete data upon follow-up in 2007. High-resolution photography of the back was conducted for all subjects at both points. Almost three-fourths (74%) of the subjects analyzed were white, and males accounted for more than half the sample (62%).

At baseline in 2004, 53% of subjects reported having had a sunburn (defined as "pink or red skin") at least once the previous summer, and this proportion remained similar (55%) at follow-up, a nonsignificant difference. Actual incidence of tanning also changed little. At both baseline and follow-up, about 85% of students reported having gotten a tan the previous summer (Pediatrics 2012;129:309-17).

Sunscreen use, meanwhile, dropped sharply. In 2004, 50% of students reported that they used sunscreen "often or always" when outside for 6 or more hours in the summer. By 2007, only 25% reported the same, a significant difference.

The children in the study with the highest risk of developing skin cancer – those with pale skin – experienced the sharpest increase in reported sunburns, Dr. Dusza and his colleagues found. In 2007, fair-skinned children were 40% more likely to report two or more recent sunburns than in 2004. By contrast, children with light olive to black skin were 70% less likely to report two or more recent burns at follow-up, compared with baseline.

Some 53% of students reported "liking a tan" at age 10, but 66% did by age 13, a significant difference. And although 22% of 10-year-olds reported deliberately spending time in the sun to get a tan, a full 40% did so at follow up, also a significant difference. Girls were twice as likely to report liking a tan in 2007, compared with 2004 (odds ratio, 2.4). Boys also were more likely to report liking a tan when they reached age 13 (OR, 1.5).

01/23/12  

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FROM PEDIATRICS

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Vitals

Major finding: At baseline in 2004, 53% of subjects reported having had a sunburn at least once the previous summer, and this proportion remained similar (55%) at follow-up. In 2004, 50% of students reported that they used sunscreen "often or always" when outside for 6 or more hours in the summer. By 2007, only 25% reported the same, a significant difference.

Data Source: Linked data from 360 children interviewed at age 10 years and again at age 13 at schools in Framingham, Mass.

Disclosures: The study was funded by the National Institutes of Health, as part of an ongoing study of nevi in children. Dr. Dusza and colleagues reported that they had no relevant financial disclosures.