Surprising results of a new Yale University skin cancer study found that more than 25% of people who had survived malignant melanoma never use sunscreen. An even greater number of skin cancer survivors ignore advice to wear hats, long sleeves and slacks to protect their skin from additional sun damage and possible cancer reoccurrence. Perhaps most shocking was the admission by 2% of those surveyed that they had used a tanning bed after recovery from skin cancer.

On average, skin cancer survivors are more careful about protecting themselves from sun exposure than the general population. According to the study, 32% of cancer survivors always wear sunscreen, nearly twice as many as other adults. However, despite a risk of future melanoma that is 9 times greater than the norm, cancer survivors were as unlikely as their non-cancer peers take other preventive measures. According to the Skin Cancer Foundation, melanoma kills 9,000 Americans each year.

University of Texas cancer researcher Mary Tripp told USA Today that it is not unusual for skin cancer survivors to let down their guard:

“When someone is first diagnosed, they are practicing sun protection, but as the years go by, maybe they tend to fall back on their old habits. A lot of melanoma survivors have told me that it is very important for them to maintain a normal outdoor lifestyle.”

If you have survived malignant melanoma, there’s no need to give up the outdoor activities you love; but it is smart to take measures to protect yourself against the return of skin cancer. The Skin Cancer Foundation offers these guidelines:

• Use a broad spectrum sunscreen that protects against both UVA and UVB rays.

• For everyday use, sunscreens of SPF 15 should offer adequate protection. For extended outdoor activity, choose a water-resistant sunscreen of SPF 30 or higher.

• For best protection, apply sunscreen 30 minutes before going outdoors and reapply every 2 hours.