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Counseling to Prevent Skin Cancer: U.S. Preventive Services Task Force Recommendation FREE

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The full report is titled “Behavioral Counseling to Prevent Skin Cancer: U.S. Preventive Services Task Force Recommendation Statement.” It is in the 3 July 2012 issue of Annals of Internal Medicine (volume 157, pages 59-65). The author is V.A. Moyer, on behalf of the U.S. Preventive Services Task Force.

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Ann Intern Med. 2012;157(1):I-36. doi:10.7326/0003-4819-157-1-201207030-00453
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Who developed these guidelines?

The U.S. Preventive Services Task Force (USPSTF) is a group of experts that makes recommendations about preventive health care.

What is the problem and what is known about it so far?

Skin cancer is the most common cancer in the United States. Several different types exist: basal cell carcinoma, squamous cell carcinoma, and melanoma. Basal cell and squamous cell carcinoma are the most common and, with timely treatment, they usually do not lead to major problems or death. Melanoma is less common but is more difficult to treat and can be deadly. Persons with fair skin, light hair and eye color, or freckles or who sunburn easily have a higher risk for skin cancer than do people with darker skin.

Exposure to ultraviolet radiation from natural sunlight or tanning booths increases skin cancer risk. Thus, counseling persons during health care visits to reduce sun exposure by using sunscreen, wearing protective clothing, and avoiding tanning booths or outdoor sun might be helpful. However, whether such counseling is effective in reducing risky behaviors and skin cancer was uncertain. The negative effects of such counseling could include vitamin D deficiency because sun exposure helps the body produce this vitamin or physical activity may be reduced from avoidance of outdoor activities.

When the USPSTF last developed recommendations on this topic in 2003, it found too little information to recommend for or against counseling to prevent skin cancer in patients of any age. The USPSTF wanted to update these recommendations.

How did the USPSTF develop these recommendations?

The USPSTF reviewed studies about the benefits and harms of counseling to prevent skin cancer published since 2003.

What did the authors find?

Acceptable-quality studies show that counseling during primary care visits about avoiding sun exposure can increase the use of sun-protective behaviors by a moderate amount among persons aged 10 to 24 years. However, most studies included only people with fair skin. The authors found no direct evidence that counseling to prevent skin cancer improves patient outcomes in persons in other age groups. Available studies showed no harms associated with counseling about sun-protective behaviors.

What does the USPSTF recommend that patients and doctors do?

The USPSTF recommends that doctors counsel persons with fair skin who are 10 to 24 years of age about sun-protective behaviors.

It concludes that there is not enough evidence to assess the balance of benefits and harms of counseling people in other age groups about sun-protective behaviors.

What are the cautions related to these recommendations?

These recommendations apply to children, adolescents, and adults at increased risk for skin cancer due to a fair skin type. The balance of benefits and harms may be different in patients with a history of skin cancer.

This article was published at www.annals.org on 8 May 2012.





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