People in the United States aren’t protecting themselves sufficiently against the sun’s harmful rays, according to a recent study.

Overall, respondents to a recent large nationwide survey by Advanced Dermatology, a Chicago dermatology practice, found a concerningly low level of consistent sunscreen use, which is vital for preventing skin cancer, the most common malignancy in the United States.

In addition, an analysis of Google search trends showed low levels of worry about skin cancer in a swath of states.

The dermatology practice conducted a nationwide survey of 2,015 U.S. residents. More than half were women, just under three quarters were white and the average age was 38.

Four in 10 of the respondents reported never wearing sunscreen, and seven in 10 said they only did so in the summer. Also, sunscreen users said they limit their use to certain occasions on sunny days.

Just under a quarter of the respondents said they wear sunscreen most of the time. This, according to the investigators, is a cause for concern because some three quarters did not know the major signs of skin cancer. Furthermore, only a bit more than half have ever received a skin cancer screening from a health provider.

The investigators also analyzed Google searches that suggest skin cancer concern, broken down by state, and compared them with skin cancer diagnosis trends.

They found that people in nine states, including the high-risk sunny states Florida and Hawaii, showed evidence of having a population that is extremely concerned about getting skin cancer. However, people living in 24 other states are apparently insufficiently concerned about skin cancer. 

To read a review of the study by Advanced Dermatology, click here.