ESPE Abstracts (2014) 82 P-D-1-2-36

Sun Protection Habits and Calcium Intake in Children with Malignancy

Yael Levy-Shragaa,b, Orit Pinhas-Hamiela,b, Michal Ben Amia,b, Yonatan Yeshayahua,b, Vered Temamc, Rinat Cohend & Dalit Modan-Mosesa,b


aPediatric Endcrinology unit, The Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel; bThe Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel; cDepartment of Pediatric Hematology–Oncology and BMT, The Edmond and Lily Safra Children’s Hosptial, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel; dMeuhedet Health Services, Tel Aviv, Israel


Background: U.V. radiation exposure is the major environmental risk factor for skin cancers. However, sun avoidance leads to inadequate vitamin D levels which impair bone health. Moreover, numerous studies linked decreased sunlight exposure to non-skin cancer incidence or survival.

Objective and hypotheses: To compare sun habits in a cohort of paediatric patients with a history of malignancy to healthy controls. We hypothesized that sun exposure will be decreased in the study group since patients are firmly instructed to avoid sun exposure during therapy. Secondly, we assessed calcium intake of both groups.

Method: Sun habits, as well as calcium intake, were assessed by validated questionnaires in 143 children with a history of malignancy (aged 11.2±4.6 years, male=68, mean interval from diagnosis 4.4±3.8 years) and 150 healthy controls (aged 10.4±4.8 years, male=67). Pertinent clinical data of patients were obtained from their charts.

Results: Patients and healthy controls reported a similar time of sun exposure during weekdays (94±82 min/day vs 81±65 min/day; P=0.83). However, during the weekend patients spent significantly less time outside compared to controls (103±85 min/day vs 124±87 min/day; P=0.015). Time elapsed from diagnosis was positively correlated with time spent outside both during weekdays (r=0.194, P=0.02) and weekends (r=0.217, P=0.009). Patients were more likely than controls to wear a hat when in the sun (34.5 vs 20.7% reporting ‘always’ or ‘frequently’; P=0.009). There was no difference between the two groups regarding other sun protection habits such as using sunscreen, wearing a shirt covering the shoulders, staying in the shade or wearing sunglasses. Daily calcium intake of both groups was suboptimal, reaching only 52% of the RDA in adolescents, with no significant difference between patients and controls.

Conclusion: Sun exposure of children with a history of malignant disease is decreased compared to healthy control. The combination of sunlight avoidance and inadequate calcium intake might have deleterious implications for their bone health.

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