Reduced Melanoma After Regular Sunscreen Use: Randomized Trial Follow-Up

Abstract

Regular sunscreen use prevents cutaneous squamous cell carcinoma long term, but the effect on melanoma is highly controversial. We evaluated whether long-term application of sunscreen decreases risk of cutaneous melanoma. In 1992, 1,621 randomly selected residents of Nambour, a township in Queensland, Australia, age 25 to 75 years, were randomly assigned to daily or discretionary sunscreen application to head and arms in combination with 30 mg beta carotene or placebo supplements until 1996. Participants were observed until 2006 with questionnaires and/or through pathology laboratories and the cancer registry to ascertain primary melanoma occurrence. Ten years after trial cessation, 11 new primary melanomas had been identified in the daily sunscreen group, and 22 had been identified in the discretionary group, which represented a reduction of the observed rate in those randomly assigned to daily sunscreen use (hazard ratio [HR], 0.50; 95% CI, 0.24 to 1.02; P = .051). The reduction in invasive melanomas was substantial (n = 3 in active v 11 in control group; HR, 0.27; 95% CI, 0.08 to 0.97) compared with that for preinvasive melanomas (HR, 0.73; 95% CI, 0.29 to 1.81). Melanoma may be preventable by regular sunscreen use in adults.