Risk attitudes and sun protection behaviour: Can behaviour be altered by using a melanoma genomic risk intervention?

Rachael L Morton; Rebecca Asher; Edward Peyton; Anh Tran; Amelia K Smit; Phyllis N Butow; Michael G Kimlin; Suzanne J Dobbinson; Sarah Wordsworth; Louise Keogh; Anne E Cust

doi:10.1016/j.canep.2019.05.002

Risk attitudes and sun protection behaviour: Can behaviour be altered by using a melanoma genomic risk intervention?

Cancer Epidemiol. 2019 Aug:61:8-13. doi: 10.1016/j.canep.2019.05.002. Epub 2019 May 15.

Authors

Affiliations

¹ NHMRC Clinical Trials Centre, Sydney Medical School, The University of Sydney, Australia; Melanoma Institute Australia, The University of Sydney, Australia. Electronic address: rachael.morton@ctc.usyd.edu.au.
² NHMRC Clinical Trials Centre, Sydney Medical School, The University of Sydney, Australia.
³ Melanoma Institute Australia, The University of Sydney, Australia; Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Australia; Sydney Health Ethics, Sydney School of Public Health, The University of Sydney, Australia.
⁴ Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, The University of Sydney, Australia.
⁵ The University of the Sunshine Coast and Cancer Council Queensland, Brisbane, Australia.
⁶ Cancer Council Victoria, Melbourne, Australia.
⁷ Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, UK.
⁸ Centre for Health Equity | Melbourne School of Population and Global Health, University of Melbourne, Australia.
⁹ Melanoma Institute Australia, The University of Sydney, Australia; Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Australia.

PMID: 31102918
DOI: 10.1016/j.canep.2019.05.002

Abstract

Background: Exposure to ultraviolet radiation from sunlight is directly associated with melanoma skin cancer, however reducing sun-exposure can be difficult to achieve at a population level.

Methods: Using a genomic risk information behaviour change trial for melanoma prevention, we classified participants as risk-seeking, risk-neutral or risk-averse for domain-specific risk taking (DOSPERT). One-way ANOVA determined the association between socio-demographic characteristics and risk-taking score, and multivariable linear regression ascertained impact of an individual's underlying risk propensity on an objective measure of sun-exposure, standard erythemal dose (SED), at 3-months follow-up.

Results: Of 119 participants, mean age 53 years; 50% males, 87% had a personal/family history of cancer; 19% were classified risk-seeking, 57% risk-neutral. The mean risk-taking score was significantly higher in younger participants (≤50 years: 13.86 vs. >50 years: 11.11, p = 0.003); and lower in those with a personal/family history of skin cancer versus without (10.55 vs 13.33, p = 0.009). Risk averse individuals had lower weekly mean SEDs at 3-months than risk neutral and risk seeking individuals (2.56, 5.81, 4.81 respectively, p = 0.01). Risk seekers showed fewer sun protective habits (p < 0.001); and higher intentional tanning, (p = 0.01). At 3-months, risk seekers attained 16%-54% lower SEDs in the genomic information group compared with controls, however this was not significantly different across risk groups (interaction p = 0.13).

Conclusion: An individual's underlying risk attitude is likely associated with sun-exposure behaviours, and may modify the effect of a genomic risk information behaviour change intervention. Young people and risk seekers may benefit most from being given information on their genetic risk of melanoma.

Keywords: Behaviour change; DOSPERT; Genomics; Health economics; Melanoma; Prevention; Risk aversion; Risk-taking.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Female
Genomics / methods*
Health Behavior / physiology*
Health Knowledge, Attitudes, Practice
Humans
Male
Melanoma / prevention & control*
Middle Aged
Risk-Taking
Skin Neoplasms / prevention & control*
Sunbathing / psychology*
Sunlight / adverse effects*