Family Programme Boosts Sun Safety for Children Facing Higher Melanoma Risk
A family programme helped children of melanoma patients adopt better sun protection habits, though it did not reduce their sunburn rates.
Children whose parents have melanoma face twice the lifetime risk of developing the disease themselves. Melanoma is a serious type of skin cancer that begins in pigment-producing cells. A researcher at Huntsman Cancer Institute at the University of Utah has developed a programme to teach melanoma patients and their children behaviours that may help prevent the disease later in life.
Yelena Wu, PhD, an investigator at Huntsman and professor of dermatology at the University of Utah, found that her FLARE programme, short for Family, Lifestyles, Actions, and Risk Education, improved sun protection behaviours among children at increased risk.
“Prevention that happens in childhood is so important for avoiding skin cancer later in life. Children’s skin is very vulnerable, and early sunburn patterns are predictive of later skin cancer risk,” says Wu. “We’re developing different programmes to make it easier for families and others to adopt health behaviour changes that will improve skin cancer prevention.”
Wu says children of melanoma patients face a higher risk because of biological factors, such as skin tone and genetics, that can increase their sensitivity to the sun. Environmental factors also play a role, including sun exposure patterns, some of which are shaped by their parents. Despite their increased risk, these young people may engage in behaviours such as tanning and neglecting sun protection. According to the National Cancer Institute, sunburns during childhood are a strong predictor of skin cancer, particularly melanoma.
The main way to reduce risk is to limit exposure to ultraviolet radiation from the sun and artificial sources and prevent sunburn, especially during childhood. Protective measures include wearing long-sleeved shirts, sunglasses, and wide-brimmed hats, avoiding outdoor activities during peak exposure hours, and applying and reapplying sunscreen.
“We need to find a way to counsel families and their kids on how important this is to manage their risk through sun-protective behaviours. This is particularly important in the Mountain West and the area we serve, where we have higher-than-average melanoma rates,” says Wu. “Skin cancers like melanoma can be highly preventable, but in a way that I think is very challenging because it requires a daily, consistent set of health behaviours. We want to support families and others in our community in making those changes and sustaining them.”
Wu adds that Utah has the highest melanoma incidence rate in the country. Data from the National Cancer Institute and the Centres for Disease Control and Prevention indicate that Utah has consistently recorded one of the highest age-adjusted melanoma incidence rates among US states in recent years. Factors that may contribute include higher elevation, outdoor lifestyles, and a predominantly fair-skinned population.
To evaluate the programme, Wu enrolled 364 pairs of patients and their children in a study aimed at improving sun safety behaviours. One group participated in FLARE, a three-session telehealth programme covering melanoma risk awareness, strategies for implementing sun protection within families, and collaborative parent-child problem-solving to address barriers to sun safety. The sessions included visual aids and videos to make the lessons more accessible. Another group met with a health educator to receive more general information about melanoma.
The randomised clinical trial, published in JAMA Dermatology, involved children aged 8 to 17 years who had experienced at least one sunburn in the previous year.
Wu found that FLARE reduced overall sun exposure and skin damage but did not lower sunburn rates. Compared with the control group, participating families were more likely to use hats and sunglasses, seek shade, avoid peak ultraviolet radiation hours, and apply and reapply sunscreen.
“Reducing sunburn is the holy grail for outcomes for skin cancer prevention because it’s such a strong indicator of skin cancer risk later in life. We still have work to do to make FLARE have the strongest possible outcome,” says Wu. “But I’m really excited that we were able to improve their skin cancer prevention behaviours, and I still consider the study a success as it shows that family-based programmes can change how kids and parents think about and implement sun safety.”
Experts note that family-based behavioural interventions can improve preventive behaviours, although additional strategies may be needed to achieve sustained reductions in sunburn among children at increased familial risk of melanoma. Consistent sun protection remains a key public health priority for reducing future skin cancer incidence in high-risk groups.
Research at Huntsman Cancer Institute is supported by the National Institutes of Health and National Cancer Institute, including cancer centre support grant P30 CA042014, as well as the Huntsman Cancer Foundation.