Fair-skinned teenagers and young adults, as well as the parents of fair-skinned children, should receive counseling from their doctors on how to avoid ultraviolet radiation that can lead to skin cancer, according to new recommendations from the U.S. Preventive Services Task Force (USPSTF), an independent panel of preventive health experts.
The recommendations are primarily for people with fair skin who are under the age of 25. For older fair-skinned people — and people with different skin types — doctors should consider their patients’ risks and preferences when deciding whether or not to counsel them about altering their behaviors to prevent skin cancer, the experts say.
That doesn’t mean, of course, that those people don’t need to worry about sun damage and skin cancer. Everybody is at risk.
Minnesotans have higher incidence
Indeed, skin cancer is the most common cancer in the United States. About 9,500 Americans are diagnosed with skin cancer each day, according to the American Academy of Dermatology. All forms of skin cancer can be deadly, but melanoma, which develops in the melanocytes, or cells that give skin its color, is considered the most serious form of the disease. Melanoma accounts for only 2 percent of all skin cancer cases, but is responsible for 80 percent of skin cancer deaths.
In recent years, the incidence of melanoma among younger adults in the U.S. has been rapidly rising. A Mayo Clinic study published in 2012 reported an eightfold increase between 1970 and 2009 in the melanoma incidence among young women (aged 18 to 39) and a fourfold increase among young men.
Minnesota has a particularly high incidence of melanoma — the highest in the Midwest, according to a 2017 study. (As I’ve reported here before, that higher incidence may be because of the state’s large white population — around 85 percent — and/or because Minnesota’s health-care system does a better job of detecting skin cancers than the systems in many other states.)
Although the cause of all melanomas is not clear, most are believed to be the result of exposure to ultraviolet (UVA and UVB) radiation from sunlight or tanning lamps and beds. Fair-skinned people — those with ivory or pale skin, light hair, light eye color and freckles or who sunburn easily — are at particularly high risk of developing skin cancer. Other people at high risk are those with many moles, a family history of skin cancer, an HIV infection or a history of an organ transplant.
Counseling works — for some
To come to their current recommendations, the USPSTF experts reviewed 21 studies conducted between 2009 and 2016 on the effectiveness of behavior counseling for getting people to take comprehensive steps (not just slapping on sunscreen) to protect themselves (or their children) from the damage of ultraviolet light.
They found the the interventions made the most difference in lowering sun-cancer risk when children, teenagers and adults under the age of 25 were the focus of the counseling.
As the task force points out, that’s an important age group. “A substantial body of observational evidence demonstrates that the strongest connection between ultraviolet radiation exposure and skin cancer results from exposure in childhood and adolescence,” the USPSTF experts write.
The task force also recommended, however, that doctors consider counseling other patients on the dangers of sun exposure, particularly when they are at high-risk for developing skin cancer.
Protect yourself now
So, don’t be surprised if your sunbathing habits come up at your next visit to your physician (or your child’s physician). Don’t wait until then, however, to protect you and your family from the sun. Skin cancer is almost always preventable. Here are the key steps (as recommended by the CDC) you should take:
Stay in the shade, especially during midday hours [10 a.m. to 4 p.m.].
Wear clothes that cover your arms and legs.
Wear a wide brim hat to shade your face, head, ears and neck.
Wear wraparound sunglasses that block both UVA and UVB rays.
Use sunscreen with sun protection factor (SPF) 15 or higher, for both UVA and UVB protection.
Avoid indoor tanning.
FMI: The USPSTF recommendations were published in the Journal of the American Medical Association (JAMA), where they can be read in full. For more information about skin cancer, including how to the recognize the signs and symptoms of the disease, go to the American Cancer Society’s website.
Correction: This story has been edited to make it clearer that the USPSTF recommendations focus on fair-skinned children and young adults under the age of 25 because exposure to UV rays as a child puts people at the greatest risk of skin cancer.