An innovative application of a decision tree analytic approach demonstrates the interactive, and sometimes counterintuitive, effects of multiple sun-protective behaviors on likelihood of sunburn, according to a recent analysis. Given the scope of those affected and enormous associated health care costs, improving efforts in skin cancer prevention has the potential for a significant effect on public health. This cross-sectional study used a nationally representative sample of 31,162 US adults from the 2015 National Health Interview Survey. Data were collected from January 1 through December 31, 2015. Researchers found:

• In the study population of 28,558 respondents with complete data, 20 patterns of sun protection were identified.
• Among 15,992 sun-sensitive individuals, those who used only sunscreen had the highest likelihood of sunburn (62.4%).
• The group with the lowest likelihood of sunburn did not report using sunscreen but engaged in the other 3 protective behaviors (24.3% likelihood of sunburn).
• Among 12,566 non-sun-sensitive individuals, those who engaged in all 4 protective behaviors had the lowest likelihood of sunburn (6.6%).
• The highest likelihood of sunburn was among those who only reported sunscreen use (26.2%).