Discussion
In the current study we compared sun exposure and protection habits in a cohort of pediatric
patients with a history of malignancy to those of healthy controls, and identified factors associated
with sun behavior in this population. Patients and healthy controls reported a similar
duration of sun exposure during weekdays, while during the weekend patients spent significantly
less time outside compared to controls. A possible explanation for this finding is that sun-exposure during week-days is dictated mainly by the school-day schedule, whereas outdoor
activities during the weekend are actively chosen by the child and the family and are thus
more likely to be influenced by disease-associated factors such as energy level or a wish to
avoid sun exposure. Time elapsed from diagnosis was positively correlated with sun exposure
both during weekdays and weekends. Patients were more likely than controls to wear a hat
when in the sun but there were no differences between the two groups regarding other sun protection
measures. Using the composite sun protection score, there was only a trend toward a
difference in favor of the study group (3.2±0.6 vs. 3.0±0.5; p = 0.07). This latter finding indicates
that although patients are instructed to adopt sun protection habits, the adherence to
these instructions is incomplete and should be improved.