At This Stage in the Game: Knowledge, Attitudes and Behaviours of Sportspeople and Sun Exposure

There is much that we currently know about skin cancer, its types, why they occur, how we can introduce preventative methods. At present, melanomas represent 1% of skin cancers diagnosed, which while seemingly small, melanomas are typically associated with higher mortality. Consistently, UV radiation exposure is the modifiable risk factor for developing a melanoma, but the type of sun exposure also influences the clinicopathological type:

-Intermittent sun exposure or sunburn during childhood and adolescence predisposes to superficial spreading melanoma,

-Chronic sun exposure predisposes lentigo malign melanoma.

-Nodular melanomas have been connected to both sporadic and chronic sun exposure.

In addition to UV exposure, it is important to note that there are additional factors that have affected the incidence of skin cancers, particularly melanomas: increased life expectancy, early detection practices, and social trends. However, there is also a large part of worldwide culture that plays a part in cancer prevention, sport!

There are a variety of studies that have shown the role that physical exercise plays in cancer prevention in reducing the incidence, recurrence, mortality, and symptoms of both disease and oncology treatments. Through regular exercise, the body is capable of enhanced DNA repair, has increased antioxidant capacity and a decreased resistance to insulin. These biomechanical factors could explain the plausibility of physical activity in cancer prevention.

So, what about skin cancer in particular? Unfortunately, the human research that has been inconclusive in answering this question. This is due to sun exposure being a variable that accompanies physical exercise.

As we have previously found in our extreme outdoor based articles (1, 2, 3), those who perform sport outdoors have greater risk of skin cancer and the occurrence of pigmentation and lesions is higher.

After reviewing 486 articles on this topic, the work of Ruiz et al detailed the findings of 23 articles which evaluated a total of 10,445 sportspeople

-Sports included: runners/athletics, cycling, golf, volleyball, skating, hockey, surfing, kitesurfing, windsurfing, sailing, swimming, rowing, and rugby

-More male than female participants, age range 15-65

-Most commonly Type III (70%)

Overall, the literature showed that sportspeople were moderately well informed about photoprotection measures, but most do not show good photoprotection habits. This was exhibited by an overall statistic of more than 80% of sportspeople being aware of the associated risks of sun exposure and skin cancer but less than 50% of participants using a topical photoprotectant. Alongside this, it was observed in one study that there was a significant increase in the occurrence of sunburn in those who had a higher number of training hours.

In addition to the number of hours spent in training, it seems that skin type and predisposition are not the only biological factors that can increase likelihood of sunburn. It was theorised within this research that where an increase perspiration is present, this will require additional photoprotective measures. This is due to sweat influencing the hydration of the corneal (outermost) layer of skin, causing less reflection and dispersion of UV light. Who knew?

Whilst topical solar protection was most popular, sunglasses, long sleeves and caps were also donned. However, this was found not to be for photoprotection purposes but rather as a method to enhance their sporting performance. Examples being hats used to be able to see the path of the ball and helmets as a safety measure in cycling.

There were many statistics encapsulated in this piece of research that have been bulleted below. But as the number of articles produced around this subject continue to increase as they have over the years, it may be likely skin cancer is blind-siding the sporting community.

Recent Articles