Many melanoma survivors forgo sunscreen and use indoor tanning beds after recovering from the disease, according to research conducted at the Yale Cancer Center.

Led by Anees Chagpar, associate professor of surgery at Yale School of Medicine, researchers analyzed self-reported data from 171 melanoma survivors and presented their findings at the American Association for Cancer Research Annual Meeting in Washington, D.C., last week. The research team found that though many survivors take precautions to protect themselves from further melanoma risk, a significant percentage of skin cancer survivors do not. According to the study, 27.3 percent of melanoma survivors nationwide report never wearing sunscreen, 15.4 percent report rarely or never staying in the shade, and 2.1 percent report continued use of indoor tanning salons.

Chagpar said her findings indicate a need for physicians to educate cancer survivors about precautions they can take to avoid further melanoma risk.

“We’ve come a long way in terms of treating melanoma, but we can be doing a better job in terms of educating our patients,” Chagpar said. “We need to convey to survivors that they can be proactive about protecting their skin.”

Chagpar said the research team used data from the National Health Interview Survey, which she called the country’s largest source of health statistics. The data was drawn from the NHIS’s 2010 study and surveyed 27,120 people. Among the population studied, 171 individuals were self-reported survivors of melanoma. Chagpar said NHIS statistics are “population representative” — the 171 survivors surveyed represent a population of 697,309 melanoma survivors nationwide.

Evaluating melanoma survivors and noncancer patients, Chagpar and her team contrasted the sun-protective practices of these two populations. The researchers found that melanoma survivors were more likely to report using sunscreen, and that 2 percent of melanoma survivors reported using a tanning bed within the previous year, compared to nearly 5.5 percent of noncancer survivors. Chagpar said though 2 percent may not seem like a significant proportion of melanoma survivors, she considers the finding important because tanning is an active behavior that puts survivors at risk.

“You would think melanoma survivors would do everything they could to avoid getting cancer again,” said study co-author Donald Lannin, Yale School of Medicine professor of surgery. “It’s interesting to try to understand why patients are engaging in dangerous behavior.”

The research team’s findings have opened up new channels for research, Chagpar said. Since finishing their evaluation of the NHIS data, the researchers have been considering factors that might explain survivors’ decisions to put themselves at risk. Chagpar said the team determined that medical institutions might need to focus more on educating survivors on precautionary behavior, and physicians might also need to communicate with patients to ensure they do not become despondent and self-destructive after recovering from cancer. The research team is using its findings to evaluate the possibility that tanning is an addictive behavior, she added.

Since the data collected in this study came solely from database analysis, Lannin said researchers also hope to understand these findings by interviewing patients about their motivations in forgoing skin protection. Chagpar said she also aims to use the findings to analyze other types of cancer survivors, adding that her research may shed light on the motivations of lung cancer survivors who continue smoking.

“We’re finding more ways to help patients survive cancer, but we need to make sure they are taking action to prevent relapses,” Chagpar said.

The study’s other authors include Jeremy Puthumana ’15, Leah Ferrucci, Donald Lannin and Brenda Cartmel.