MONDAY, May 7 (HealthDay News) — Doctors should take the time to
counsel children, teens and young adults on the dangers of sun exposure
and tanning beds, according to new recommendations from the U.S.
Preventive Services Task Force.
But rather than focus on skin cancer, discussions with young patients
should center on how ultraviolet-ray exposure can damage the way their
skin looks, the task force advised.
“We are not saying to young people to avoid sun exposure and indoor
tanning to prevent skin cancer, because that message doesn’t work,” said
Dr. Virginia Moyer, USPSTF chair and a professor of pediatrics at Baylor
College of Medicine in Houston.
“That is the goal, but the message that works is to use
appearance-based counseling,” she said.
Because most research so far is based on people with fair skin — who
are at the greatest risk of skin cancer — these new recommendations apply
only to them, the authors noted.
Instead of telling these patients about the risk of skin cancer, they
should be told that sun exposure leads to ugly skin: “What you end up
having is wrinkled, leathery skin,” Moyer said.
“If the audience you are trying to reach is young people whose concern
about having skin cancer is not very high, then the more effective way to
get the message across is to talk about the more immediate effects — skin
damage,” she said.
For example, doctors can show patients photos taken of skin with a UV
camera to demonstrate the damage UV rays can cause.
The recommendations appeared online May 8 in advance of publication in
the July 3 print issue in the Annals of Internal Medicine.
Specifically, doctors should counsel children, teens and young adults
aged 10 to 24 who have fair skin and no history of skin cancer about skin
cancer prevention. Having light skin, hair and eyes increases the risk for
skin cancer, as does overexposure to ultraviolet rays at an early age, the
recommendations state.
Skin cancer affects more than 2 million Americans each year, according
to background information from the USPSTF.
This recommendation is a change from the group’s previous statement,
which said that evidence was insufficient to be able to make a
recommendation at that time, Moyer said.
“We now have data that is pretty good that counseling adolescents and
young adults who are fair-skinned to avoid sun exposure, using counseling
that is appearance-based, works,” she said.
Moyer noted that early skin damage is a precursor to skin cancer later
in life. “But by the time people are concerned about the risk of skin
cancer it’s too late. The damage has been done,” she explained.
Appearance-based counseling by doctors can change behavior, Moyer said.
“It should be part of well-person exams for fair-skinned people,” she
added.
Right now there is not enough evidence to recommend counseling adults
about the dangers of UV exposure, the report noted.
Dr. Jeffrey Salomon, an assistant clinical professor of plastic surgery
at Yale University School of Medicine, said he isn’t convinced that
counseling children is enough to get them into the habit of protecting
themselves from UV exposure.
“It is always a challenge to change people’s behaviors,” he said.
Counseling and media campaigns aren’t enough. These changes must be taught
early, Salomon added.
In Australia, schools have an integrated program about sun protection,
a large media campaign and widespread availability of sun-protection
clothing and other products, he pointed out. Yet, studies show that even
in Australia, the country with the highest incidence of dangerous skin
cancers, media announcements only have short-term benefits in getting
people to comply, he noted.
“I think that there is a clear parental responsibility to protect one’s
child from the largest-known cancer risk: the sun,” Salomon said.
He noted that parents make their children wear bike helmets and buckle
seat belts and they don’t leave their children unattended.
“If children are slathered with sun-protection creams and not brought
out in the midday sun, it will ultimately seem to be the normal and
prudent thing to do,” Salomon said.
More information
To learn more about skin cancer, visit the Skin Cancer
Foundation.
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