• Posted August 3, 2023

Golfers, Don't Forget Sunscreen: Your Skin Cancer Risk Is Higher

Golfing may be a great way to get outdoors and enjoy the pleasures of a classic summer pastime. But a new study warns that walking the greens for hours on end without adequate sun protection may notably increase the risk for skin cancer.

Researchers in Australia found that more than one-quarter of golfers in that country have been diagnosed with skin cancer at some point, making Aussie players 2.4 times more likely to get the disease than their non-golfing peers.

“Our previous research, and that of others worldwide, has demonstrated the positive impact of golf on people's health, including physical, mental and cognitive well-being,” said study lead author Brad Stenner.

At the same time, “Australia is well known for its high skin cancer rates, and frequency and intensity of sun exposure,” said Stenner, a lecturer in health and human performance at the University of South Australia in Adelaide.

However, “the cumulative effects of sun exposure do increase the risks of skin cancer, regardless of where you live,” he added.

Knowing this, golfers should more actively strive to protect themselves, Stenner and other experts said.

In the new research, just 7% of those in the general public reported ever having a skin cancer diagnosis versus 27% of the golfers. This suggests golfers face a nearly 250% greater risk of developing skin cancer than non-players, the study authors said.

It's clearly not just an Aussie concern. Across the globe one in every three cancers is skin-related, with roughly 2 to 3 million non-melanoma skin cancers — and 132,000 potentially fatal melanoma skin cancers — diagnosed annually worldwide, the researchers pointed out in background notes.

For the study, Stenner and his colleagues reviewed health information gathered from an online survey of 336 players launched in 2018. Only folks who played golf at least once a month were included.

The players' responses were compared with health information gathered from nearly 16,000 Australians in the general public. All had participated in the once-every-four-years Australian Health Survey.

Stenner stressed it's possible that older golfers might have been exposed to the sun's harmful ultraviolet (UV) rays when much younger, potentially before starting to golf, and are now experiencing the impact. He also noted that his team did not collect data concerning actual exposure levels to UV radiation (UVR).

Still, he said UVR exposure is “a very well-established cause” of skin cancer.

Among golfers, his team found “a significantly higher risk, which we believe is associated with prolonged sun exposure and/or not using skin-protection strategies,” he said.

His bottom-line: “Anytime you spend time in the sun, unprotected, increases your risk of skin cancer.”

So, Stenner added, “It is important for all golfers, including younger golfers, to reduce the risk of skin cancer through the use of sun-protective strategies. We suggest and support broad-brimmed hats, sunglasses, high SPF [sun protection factor] sunscreen, reapplied regularly, and long sleeves or trousers if possible."

If you do wear short sleeves and shorts, apply sunscreen to your arms and legs, he advised.

Ashani Weeraratna, professor and chair of biochemistry and molecular biology at the Johns Hopkins Bloomberg School of Public Health, in Baltimore, agreed.

While observing that Australia is home to many light-skinned — and therefore higher risk — citizens, she said that for the most part “the dynamics should be roughly the same” when it comes to skin cancer risk and sun exposure, regardless of location or particular reason for spending lots of time outdoors.

“I can't emphasize enough the importance of SPF, whether in your clothing, your sunblock,” said Weeraratna, who was not part of the study. “For sunblock, look for broad spectrum, both UVA and UVB, SPF30. And also reapply every 90 minutes, if sweating or swimming," she said. She also recommends "good sunglasses, because melanoma can also occur in your eyes.”

Sun exposure isn't the only risk factor for skin cancer, said Dr. Arif Kamal, chief patient officer with the American Cancer Society.

In addition to light skin tone, eye color and hair color, “alcohol use, sugar-sweetened beverage ingestion, and being overweight” can raise your risk, Kamal noted.

For anyone at risk, Kamal seconded much of Stenner's advice: “Reducing sun exposure during mid-day, wearing clothing that particularly covers areas where sunscreen is difficult to apply (meaning) top of head, back of legs, or being deliberate about applying sunscreen to those areas, is crucial."

Beyond that, "being aware of skin changes and reporting those changes in a timely way to a doctor is also a key step,” Kamal said.

The findings were published online recently in BMJ Open Sport & Exercise Medicine.

More information

There's more on skin cancer at the American Cancer Society.

SOURCES: Brad Stenner, PhD, lecturer, Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia; Ashani T. Weeraratna, PhD, professor and chair, biochemistry and molecular biology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore; Arif H. Kamal, MD, MHS, chief patient officer, American Cancer Society; BMJ Open Sport & Exercise Medicine, July 20, 2023, online