As March turns (too slowly!) from lion to lamb — and with an eye on improving temperatures — the U.S. Preventive Services Task Force has offered the first of the seasonal reminders on protecting against skin cancer.
The USPSTF recently published a recommendation statement titled “Behavioral Counseling to Prevent Skin Cancer” in the Journal of the American Medical Association (JAMA).
The USPSTF notes important skin cancer statistics:
- “Skin cancer is the most common type of cancer in the United States and is generally categorized as melanoma or nonmelanoma skin cancer.”
- “Melanoma is the fifth-leading type of incident cancer, and 2.2% of adults will be diagnosed with it in their lifetime.”
- “Although invasive melanoma accounts for only 2% of all skin cancer cases, it is responsible for 80% of skin cancer deaths.”
- “Basal and squamous cell carcinoma, the 2 predominant types of nonmelanoma skin cancer, represent the vast majority of skin cancer cases.”
- “In 2018, an estimated 91 270 new cases of melanoma are expected, representing 5.2% of all new cancer cases.”
- “An estimated 9730 persons will die of the disease, representing 1.6% of all cancer deaths.”
- “Adults older than 50 years; men; and persons with fair skin types are at increased risk. Melanoma is most frequently diagnosed among adults aged 65 to 74 years; death rates are highest among the middle-aged and elderly.”
- “Melanoma is 5 times more common among Hispanic adults and 25 times more common among white than African American adults.”
Benefits of Behavioral Counseling Interventions
To create its recommendation, the USPSTF “reviewed the evidence on whether counseling patients about sun protection reduces intermediate outcomes (eg, sunburn or precursor skin lesions) or skin cancer; the link between counseling and behavior change, the link between behavior change and skin cancer incidence, and the harms of counseling or changes in sun protection behavior; and the link between counseling patients to perform skin self-examination and skin cancer outcomes, as well as the harms of skin self-examination.”
One area where a well-run workplace wellness program can help: Providing information or even behavioral counseling.
The USPSTF writes:
- “Behavioral counseling interventions target sun protection behaviors to reduce UV radiation exposure. UV radiation is a known carcinogen that damages DNA and causes most skin cancer cases.”
- “A substantial body of observational evidence demonstrates that the strongest connection between UV radiation exposure and skin cancer results from exposure in childhood and adolescence.”
- “Sun protection behaviors include the use of broad-spectrum sunscreen with a sun-protection factor of 15 or greater; wearing hats, sunglasses, or sun-protective clothing; avoiding sun exposure; seeking shade during midday hours (10 am to 4 pm); and avoiding indoor tanning bed use.”
The agency concludes: “The USPSTF concludes with moderate certainty that behavioral counseling interventions have a small benefit in adults older than 24 years with fair skin types.”