Primary Prevention Of Skin Cancer Research Articles

Knowledge of the risks of ultraviolet radiation, sun exposure attitudes and practices among Lebanese university students

BackgroundExposure to Ultraviolet radiation (UVR) is a major risk factor for skin cancer. Data about UVR risk knowledge and exposure behaviors in the Lebanese population are scarce. AimTo evaluate the association between UVR risks knowledge, attitudes, and behaviors among Lebanese university students in the aim of promoting primary prevention of skin cancer. MethodsWe conducted a quantitative cross-sectional study between January and March 2022. An online survey was sent to Saint Joseph University students in Lebanon consisting of 5 sections: sociodemographic data, skin and health status, UVR exposure and protection behaviors, attitudes towards exposure and risks’ knowledge. Descriptive analysis was conducted, in addition to bivariate analysis and logistic regression with sunburn and sunbathing as outcomes respectively. Statistical significance was defined as p < 0.05. ResultsA total of 385 students responded to our questionnaire with a mean age of 23.59. 62.1 % reported at least one episode of sunburn during the last summer. The most common sun protective measure was sunscreen application; however, its frequency wasn’t satisfactory considering the high knowledge level of UVR risks. The most frequent barrier into applying sunscreen was its expensive price (42.4 %). Furthermore, positive attitudes towards tanning, particularly among women, and sunbathing were high. 75.1 % of students sunbathed for at least one day. ConclusionLebanese university students are aware of the risks of UVR risks; however, sunburn and sunbathing are common and protective behaviors are often not applied. Future awareness campaigns for skin cancer and promotion of sun safety are necessary.

Cost-effectiveness analysis and return on investment of SunSmart Western Australia to prevent skin cancer.

Each year, malignant melanoma accounts for 57 000 deaths globally. If current rates continue, there will be an estimated 510 000 new cases annually and 96 000 deaths by 2040. Melanoma and keratinocyte cancers (KCs) incur a large societal burden. Using a mathematical population model, we performed an economic evaluation of the SunSmart program in the state of Western Australia (WA), a primary prevention program to reduce the incidence of skin cancer, versus no program. A societal perspective was taken combining costs to the health system, patients and lost productivity. The model combined data from pragmatic trial evidence of sun protection, epidemiological studies and national cost reports. The main outcomes modelled were societal and government costs, skin cancer counts, melanoma deaths, life years and quality-adjusted life years. Over the next 20 years, the model predicted that implementing the WA SunSmart program would prevent 13 728 KCs, 636 melanomas and 46 melanoma deaths per 100 000 population. Furthermore, 251 life years would be saved, 358 quality-adjusted life years gained and AU$2.95 million in cost savings to society per 100 000 population would be achieved. Key drivers of the model were the rate reduction of benign lesions from sunscreen use, the costs of purchasing sunscreen and the effectiveness of reducing KCs in sunscreen users. The likelihood of WA SunSmart being cost-effective was 90.1%. For the WA Government, the estimated return on investment was $8.70 gained for every $1 invested. Primary prevention of skin cancer is a cost-effective strategy for preventing skin cancers.

The Cost-Effectiveness of Primary Prevention Interventions for Skin Cancer: An Updated Systematic Review.

Preventing the onset of skin malignancies is feasible by reducing exposure to ultraviolet radiation. We reviewed published economic evaluations of primary prevention initiatives in the past decade, to support investment decisions for skin cancer prevention. We assessed cost-effectiveness, cost-utility and benefit-cost analyses published from 1 September 2013. Seven databases were searched on 18 July 2023 and updated on 15 November 2023. Studies must have reported outcomes in terms of monetary costs, life years, quality-adjusted life years or variant thereof. A narrative synthesis was undertaken and reporting quality was assessed by three reviewers using the Consolidated Health Economic Evaluation Reporting Standards checklist. In total, 12 studies were included with five studies located in Australia; three in North America and the remaining four in Europe. Interventions included restricting the use of indoor tanning devices (7 studies), television advertising, multi-component sun safety campaigns, shade structures plus protective clothing provision for outdoor workers and provision of melanoma genomic risk information to individuals. Most studies constructed Markov cohort models and adopted a societal cost perspective. Overall, the reporting quality of the studies was high. Studies found highly favourable returns on investment ranging from US$0.35 for every $1 spent on prevention, up to €3.60 for every €1 spent. Other studies showed substantial skin cancers avoided, gains in life years, quality-adjusted survival, and societal cost savings. From both population health and economic perspectives, allocating limited health care resources to primary prevention of skin cancer is highly favourable.

A review of skin cancer primary prevention activities in primary care settings.

Skin cancer is highly preventable through primary prevention activities such as avoiding ultraviolet radiation exposure during peak times and regular use of sun protection. General practitioners (GPs) and primary care nurses have key responsibilities in promoting sustained primary prevention behaviour. We aimed to review the evidence on skin cancer primary prevention activities in primary care settings, including evidence on feasibility, effectiveness, barriers and enablers. Rapid review and narrative synthesis. We searched published literature from January 2011 to October 2022 in Embase, Medline, PsychInfo, Scopus, Cochrane Central and CINAHL. The search was limited to skin cancer primary prevention activities within primary care settings, for studies or programs conducted in Australia or countries with comparable health systems. Analysis of barriers and enablers was informed by an implementation science framework. A total of 31 peer-reviewed journal articles were included in the review. We identified four main primary prevention activities: education and training programs for GPs; behavioural counselling on prevention; the use of novel risk assessment tools and provision of risk-tailored prevention strategies; and new technologies to support early detection that have accompanying primary prevention advice. Enablers to delivering skin cancer primary prevention in primary care included pairing preventive activities with early detection activities, and access to patient resources and programs that fit with existing workflows and systems. Barriers included unclear requirements for skin cancer prevention counselling, competing demands within the consultation and limited access to primary care services, especially in regional and remote areas. These findings highlight potential opportunities for improving skin cancer prevention activities in primary care. Ensuring ease of program delivery, integration with early detection and availability of resources such as risk assessment tools are enablers to encourage and increase uptake of primary prevention behaviours in primary care, for both practitioners and patients.

Outdoor workers' perceptions of skin cancer prevention: a qualitative study.

Outdoor workers are at increased risk for skin cancer and melanoma. This qualitative study aimed to explore outdoor workers' perspectives and experiences of primary (i.e. sun protection) and secondary prevention, i.e. skin self-examination (SSE) of skin cancer. Purposive, snowball, and theoretical sampling was used to recruit outdoor workers in Kentucky and Indiana. Semi-structured interviews via telephone or videoconference of approximately 45 min were conducted with interviewer probes and questions about perceptions of cancer risk, prevention, and screening techniques conducted, perceived barriers and facilitators, and preferences for health dissemination venues. The recordings were transcribed verbatim and de-identified. Analysis involved constructivist grounded theory coding strategies. Using peer debriefing and consensus building around themes, the researcher established a codebook for all interviews to utilize within Dedoose software for systematizing and organizing data. Eighteen interviews were conducted. Interviewees (N = 18) ranged in age from 35 to 78 yr, with 3 females. Outdoor industries included agriculture, maintenance, and grounds maintenance. Themes derived from the data showed the underlying factors and perceptions that influence outdoor workers to conduct primary and secondary cancer prevention activities. The level of alarm attributed to disease and the level of trust in information contribute to intentions to conduct activities. The intentions and trust toward healthcare institutions and providers drive the primary or secondary prevention behaviors. Cultural and contextual factors included masculinity and self-sufficiency, familial and occupational priorities, and community ties. These data provide a basis for developing future communications and interventions to decrease skin cancer incidence in outdoor workers. They indicate that secondary prevention and building self-efficacy in conducting SSE should be emphasized in tandem or over primary skin cancer prevention methods in this population. Trusted local healthcare providers should primarily provide prevention information, and materials should utilize testimonials from the local community to best influence this population. Communications and training interventions are needed in this population to induce a proactive level of alarm about cancer and result in the performance of SSE.

Skin cancers are the most frequent cancers in fair-skinned populations, but we can prevent them.

Cancers of the skin are the most commonly occurring cancers in humans. In fair-skinned populations, up to 95% of keratinocyte skin cancers and 70–95% of cutaneous melanomas are caused by ultraviolet radiation and are thus theoretically preventable. Currently, however, there is no comprehensive global advice on practical steps to be taken to reduce the toll of skin cancer. To address this gap, an expert working group comprising clinicians and researchers from Africa, America, Asia, Australia, and Europe, together with learned societies (European Association of Dermato-Oncology, Euromelanoma, Euroskin, European Union of Medical Specialists, and the Melanoma World Society) reviewed the extant evidence and issued the following evidence-based recommendations for photoprotection as a strategy to prevent skin cancer. Fair skinned people, especially children, should minimise their exposure to ultraviolet radiation, and are advised to use protective measures when the UV index is forecast to reach 3 or higher. Protective measures include a combination of seeking shade, physical protection (e.g. clothing, hat, sunglasses), and applying broad-spectrum, SPF 30 + sunscreens to uncovered skin. Intentional exposure to solar ultraviolet radiation for the purpose of sunbathing and tanning is considered an unhealthy behaviour and should be avoided. Similarly, use of solaria and other artificial sources of ultraviolet radiation to encourage tanning should be strongly discouraged, through regulation if necessary. Primary prevention of skin cancer has a positive return on investment. We encourage policymakers to communicate these messages to the general public and promote their wider implementation.

Action during childhood for lifelong primary skin cancer prevention

Action during childhood for lifelong primary skin cancer prevention

Multimodal Transplant-clinic-based Skin Cancer Prevention Education for Organ Transplant Recipients: Feasibility Study.

Patients enrolled by a transplant-clinic study nurse completed baseline questionnaires and received sun-safety brochures. For the 12-mo intervention, transplant physicians were alerted to provide standard sun-protection advice (use of hat, long sleeves, and sunscreen outdoors) by sun-advice prompt cards attached to participants' medical charts at each clinic visit. Patients indicated receiving advice from their physician and from study personnel via an exit-card postclinic, and at final study clinics, they also reported their sun behaviors by questionnaire. Feasibility of the intervention was measured by patients' and clinic staff's study engagement; effectiveness was assessed by calculating odds ratios (ORs) for improved sun protection, using generalized estimating equations. Of 151 patients invited, 134 consented (89%), and 106 (79 %) (63% male, median age 56 y, 93% of European descent) completed the study. Odds of receiving sun advice from transplant physicians and study nurses rose after the intervention compared with baseline (ORs, 1.67; 95% confidence interval [CI], 0.96-2.96 and 3.56; 95% CI, 1.38-9.14, respectively). After 12 mo of regular transplant-clinic advice, odds of sunburn decreased (OR, 0.59; 95% CI, 0.13-2.60), and odds of applying sunscreen (OR, 1.93; 95% CI, 1.20-3.09) almost doubled. Encouragement of primary prevention of skin cancer among organ transplant recipients by physicians and nurses during routine transplant-clinic visits is feasible and appears to be effective.

Skin cancer primary prevention by counseling patients with different skin tones.

Early sun exposure in pediatric and adolescent years predisposes individuals to skin cancer, and provider counseling about photoprotective behaviors can reduce this risk in both children and adults. In the United States, people with dark skin tones have higher mortality rates from skin cancer, yet there is a lower incidence of skin malignancies in these populations. Research suggests this is due to inadequate understanding and medical training regarding dermatologic disease in skin of color.

Insufficient Evidence for Screening Reinforces Need for Primary Prevention of Skin Cancer

US Preventive Services Task Force; Carol M. Mangione, MD, MSPH; Michael J. Barry, MD; Wanda K. Nicholson, MD, MPH, MBA; David Chelmow, MD; Tumaini Rucker Coker, MD, MBA; Esa M. Davis, MD, MPH; Katrina E. Donahue, MD, MPH; Carlos Roberto Jaén, MD, PhD, MS; Martha Kubik, PhD, RN; Li Li, MD, PhD, MPH; Gbenga Ogedegbe, MD, MPH; Goutham Rao, MD; John M. Ruiz, PhD; James Stevermer, MD, MSPH; Joel Tsevat, MD, MPH; Sandra Millon Underwood, PhD, RN; John B. Wong, MD

Serial Cross-Sectional Observations of Sun-Protective Behaviors at an Annual Outdoor Motorsport Event in Tropical Queensland, Australia.

Skin cancer, the most prevalent cancer in Caucasians residing at low latitudes, can primarily be prevented by avoiding overexposure to sunlight. Serial cross-sectional observations were conducted at an outdoor motorsport event held in Townsville, Queensland each July (Southern winter) to determine whether sun-protection habits changed over time. Most (71.1%) of the 1337 attendees observed (97.6% lightly pigmented skin, 64.0% male) wore a hat (any style shading the face), while few (18.5%) wore three-quarter or full-length sleeves. While hat-wearing rates (any style) were similar in 2009 (326, 72.6%) and 2013 (625, 70.4%), the use of sun-protective styles (wide-brimmed/bucket/legionnaires) decreased from 29.2% to 18.6% over the same period, primarily because the use of sun-protective hats halved (from 28.7% to 14.0%) among females, while decreasing from 29.4% to 21.1% in males. Although relatively few individuals wore sun-protective (three-quarter-length or full-length) sleeves regardless of year (OR=0.117, P < 0.0001), encouragingly, the use of sun-protective sleeves more than doubled between 2009 (10.5%) and 2013 (22.5%). Interestingly females, albeit the minority, at this sporting event were less likely to wear a hat (OR=0.473, P < 0.0001) than males. These findings highlight the need for continued momentum toward skin cancer primary prevention through sun protection with a dedicated focus on outdoor sporting settings.

Free sunscreen dispensers: A readily available asset for the primary prevention of skin cancer

To the Editor: Sunscreen is a simple, well-known medium for reducing photoaging, preventing sunburn, and reducing the risk of skin cancer. 1 Leiter U. Eigentler T. Garbe C. Epidemiology of skin cancer. Adv Exp Med Biol. 2014; 810: 120-140 PubMed Google Scholar Portable sunscreen dispensers, which are similar to soap and hand sanitizer dispensers, have the potential to greatly benefit public health and to augment skin cancer prevention efforts by increasing the accessibility of sunscreen. The COVID-19 pandemic triggered a significant decrease in the use of free sunscreen dispensers, in both public and private sector enterprises, including healthcare, recreation, and parks. 2 Eason C.D. Rundle C. Dunnick C.A. Hugh J. Dellavalle R.P. National trends in free public sunscreen dispensers. J Am Acad Dermatol. 2021; 84: 1109-1111https://doi.org/10.1016/j.jaad.2020.05.136 Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar ,3 Szeto M.D. Kokoska R.E. Maghfour J. et al. An analysis of public sunscreen distribution in the United States during the COVID-19 pandemic. J Am Acad Dermatol. 2022; 86: e241-e243https://doi.org/10.1016/j.jaad.2022.01.020 Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar In the 2018-2019 academic year, the University of Colorado Anschutz Medical Campus partnered with DEFEATMelanoma (https://defeatmelanoma.org/) and the Richard David Kann (RDK) Melanoma Foundation to provide 6 free sunscreen dispensers around the Medical Campus. 4 Ilsley B. New sunscreen dispensers, CU Anschutz Medical Campus News. https://news.cuanschutz.edu/news-stories/new-sunscreen-dispensersDate: 2018 Date accessed: March 3, 2022 Google Scholar During the pandemic, there was a considerable decrease in use of these dispensers at the Anschutz Medical Campus—notably, this represents a similar plummet to that described by Eason et al 2 Eason C.D. Rundle C. Dunnick C.A. Hugh J. Dellavalle R.P. National trends in free public sunscreen dispensers. J Am Acad Dermatol. 2021; 84: 1109-1111https://doi.org/10.1016/j.jaad.2020.05.136 Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar and Szeto et al. 3 Szeto M.D. Kokoska R.E. Maghfour J. et al. An analysis of public sunscreen distribution in the United States during the COVID-19 pandemic. J Am Acad Dermatol. 2022; 86: e241-e243https://doi.org/10.1016/j.jaad.2022.01.020 Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar Supply chain disruptions secondary to the pandemic greatly affected the availability of numerous commodities across the country, one of these being sunscreen dispensers. 5 Esper T.L. Supply chain management amid the coronavirus pandemic. J Public Policy Mark. 2021; 40: 101-102https://doi.org/10.1177/0743915620932150 Crossref Scopus (31) Google Scholar Therefore, we undertook an investigation to ascertain the range of sunscreen dispensers currently available on the market.

The impact of skin cancer prevention efforts in New South Wales, Australia: Generational trends in melanoma incidence and mortality

BackgroundIn Australia, skin cancer awareness campaigns have focused on raising the awareness and consequences of skin cancer and highlighting the importance of utilising sun protection. MethodsTrends in melanoma incidence and mortality have been explored elsewhere in Australia and this study sought to examine the trends in NSW. Anonymised incidence and mortality data for in situ and invasive melanoma from 1988 to 2014 were obtained from the NSW Cancer Registry. Trends of melanoma incidence and mortality were analysed using segmented regression to allow for changes over time. Birth cohort patterns were assessed using age–period–cohort models. ResultsOver the period, incidence of in situ melanoma increased in all age groups although the rates were lowest in those under 40 years of age. Incidence of invasive melanoma was either stable or decreased in people under 60, while it increased in those aged 60 and above, particularly in men. Age–period–cohort analysis revealed decreasing age-specific incidence of invasive melanoma under 40 years of age. Melanoma mortality over the period was stable or decreased in all groups except in men aged 60 or over. Overall, mortality rates generally declined or remained stable particularly in recent years. ConclusionIt is encouraging that rates of invasive melanoma are declining in the younger age cohorts – which could be attributed to both primary prevention efforts with individuals protecting their skin as well as early detection through self assessment and clinician performed skin checks. In addition, whilst it is important to monitor the increasing rates of in situ melanoma, the increase is likely due to early detection and treatment of melanoma that could have progressed to invasive melanoma and therefore detection whilst still in situ is an improved outcome. Overall, the results demonstrate the need to continue to improve the understanding of and compliance with primary skin cancer prevention measures in order to reduce population UVR exposure and overall melanoma incidence.

Baseline and lifetime alcohol consumption and risk of skin cancer in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC).

Experimental evidence suggests that alcohol induces cutaneous carcinogenesis, yet epidemiological studies on the link between alcohol intake and skin cancer have been inconsistent. The European Prospective Investigation into Cancer and Nutrition (EPIC) is a prospective cohort initiated in 1992 in 10 European countries. Alcohol intake at baseline and average lifetime alcohol intake were assessed using validated country-specific dietary and lifestyle questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated in Cox models. A total of 14 037 skin cancer cases (melanoma: n=2457; basal-cell carcinoma (BCC): n=8711; squamous-cell carcinoma (SCC): n=1928; unknown: n=941) were identified among 450 112 participants (average follow-up: 15 years). Baseline alcohol intake was positively associated with SCC (>15 vs 0.1-4.9 g/day: HR=1.44, 95% CI=1.17-1.77; Ptrend =.001), BCC (HR=1.12, 95% CI=1.01-1.23; Ptrend =.04), and melanoma risks in men (HR=1.17, 95% CI=0.95-1.44; Ptrend =.17), while associations were more modest in women (SCC: HR=1.09, 95% CI=0.90-1.30; Ptrend =.13; BCC: HR=1.08, 95% CI=1.00-1.17, Ptrend =.03; melanoma: HR=0.93, 95% CI=0.80-1.08, Ptrend =.13). Associations were similar for lifetime alcohol intake, with an attenuated linear trend. Lifetime liquor/spirit intake was positively associated with melanoma (fourth vs first quartile: HR=1.47, 95% CI=1.08-1.99; Ptrend =.0009) and BCC risks in men (HR=1.17, 95% CI=1.04-1.31; Ptrend =.14). Baseline and lifetime intakes of wine were associated with BCC risk (HR=1.25 in men; HR=1.11-1.12; in women). No statistically significant associations were found between beverage types and SCC risk. Intake of beer was not associated with skin cancer risk. Our study suggests positive relationships between alcohol intake and skin cancer risk, which may have important implications for the primary prevention of skin cancer.

Incongruence between Physician, Patient, and Medical Chart Report of Skin Cancer Prevention Counseling.

Skin cancer incidence in the United States has risen rapidly in recent decades, underscoring the need for accessible and effective prevention practices. Skin cancer prevention counseling can lead to increased sun protective behavior and early detection; however, little is understood regarding the frequency and content of counseling among primary care providers (PCPs). We performed multi-center cross-sectional surveys among 53 providers and 3343 of their patients and chart review asking whether skin cancer prevention counseling occurred and details of that counseling. Only 10–25% of patients reported that counseling occurred. Among the providers who reported counseling, there were higher odds that their patients recollected they were advised to use sunscreen or protective clothing, on how to use sunscreen, on signs of skin cancer, to perform a self-skin exam (all p < 0.001), and were provided with written materials (p < 0.01). Eight percent of prevention counseling was chart documented despite being highly associated with patient and physician recollection of counseling (p < 0.001). These results highlight the need for consistent and clear delivery of skin cancer primary prevention.

What can Aotearoa New Zealand learn from the Australian Sunsmart Story? A qualitative study

ObjectiveTo explore the views of stakeholders in Australia concerning skin cancer primary prevention and identify successful strategies used that may be translatable to other jurisdictions. MethodsIn‐depth stakeholder interviews with experts engaged in skin cancer prevention advocacy and action in Australia. ResultsA number of important facilitators were identified including: the use of good scientific evidence (including economic), strong leadership, legislation and strategic documents, engaging the media particularly with the use of personal stories and garnering public support. A number of barriers were also identified including: a lack of funding (particularly nationally), variation by state, apathy and the long latency of skin cancer. ConclusionsAdvocates identified a number of key strategies that were used to gain momentum in achieving Australia's comprehensive Sunsmart program. These included: strong leadership, legislation including that banning solaria and workplace health and safety legislation, a critical mass of key advocates from a range of disciplines including clinicians and patients, and the advantageous use of media to drive change. Implications for public healthAustralia demonstrates what can be achieved when skin cancer prevention is taken seriously. The challenge for other nations is to apply the lessons learnt in Australia to our own jurisdictions.

Generating political priority for skin cancer primary prevention: A case study from Aotearoa New Zealand.

Skin cancer is highly prevalent but preventable, yet little research has been done on the challenges in generating political priority for skin cancer prevention. This qualitative study aimed to identify the political challenges to, facilitators of, and strategies to strengthen skin cancer prevention. The focus was on the case of Aotearoa New Zealand (NZ): a country with high skin cancer rates, but limited investment in primary prevention. Data sources included 18 national key informant interviews and documentary analysis. Data were analysed inductively for emerging themes and framed using a conceptual framework of political priority. Challenges to advocates for skin cancer primary prevention include limited resources and competing priorities. Political-level challenges include a lack of quick results compared with other initiatives vying for political attention, lack of negative externalities and, in NZ, misalignment with health system priorities. Challenges in the evidence base include the perceived conflict of sun protection with Vitamin D and physical activity, the lack of data on the financial burden of skin cancer and relatively low temperatures in NZ. Facilitators include strong policy community cohesion and issue framing, and weak opposition. Promising strategies to strengthen skin cancer prevention in NZ could include network building, using framing that resonates with policy makers and addressing key knowledge gaps in NZ, such as the financial burden of skin cancer. Advocacy for skin cancer prevention faces challenges due to advocates' limited resources, political challenges such as lack of quick results and gaps in evidence. Nonetheless, the initiative encounters little opposition and can be framed in ways that resonate with policy makers. SO WHAT?: Skin cancer is highly preventable, but advocates for prevention initiatives have struggled to gain political traction. This study identifies several strategies that could help raise the political profile for skin cancer prevention.

Ageing research: rethinking primary prevention of skin cancer.

Ageing research: rethinking primary prevention of skin cancer.

Results of a 10-year web-based health promotion campaign against skin cancer in Switzerland.

Skin cancer is the most common malignancy with rising incidence. Although early detection can be lifesaving, prevention programmes are under-utilized. In 2008, a group of board-certified dermatologists in Switzerland established a website aimed at educating about skin cancer risk factors and providing guidance on self-assessment. To present the data of this programme over the last 10 years with regards to representation of the targeted groups and sustained impact on primary skin cancer prevention. A comprehensive web-based health promotion campaign was established for education and guidance on self-assessment. Teledermatological evaluation was offered and participants were then interviewed. In total, 11,171 digital photos were evaluated during 2008-2018; 54.3% (n = 6,067) from females and 45.7% (n = 5,104) from males. In 26.7% (n = 2,983), clinical examination was recommended. Of the participants, 1,874 replied revealing 103 malignancies (9.2% of the lesions were presented to a physician): 34 melanomas in situ, six squamous cell carcinomas, 53 basal cell carcinomas and 10 malignant lesions (not further specified). Of the participants, 40.5% (n = 683) changed their attitude towards sun exposure, 48.7% (n = 820) used more sunscreen, and 57.5% (n = 966) improved sunscreen measures. Web-based educational programmes raise public awareness, enhance prevention, and support early diagnosis of skin cancer. Teledermatology might contribute to reducing skin cancer mortality rates.

Expert Consensus on Sunscreen for the Primary Prevention of Skin Cancer: Results of the Skin Cancer Prevention Working Group Conference

Background: Melanoma and non-melanoma skin cancers (NMSC) are the overall most common type of malignancy. Despite this fact, the use of sunscreen as a primary preventative measure for skin cancer is not ubiquitous. Objective: To review the literature regarding efficacy and safety of sunscreens and to process and condense data into overarching principles to provide guidance to the general public and improve outcomes for melanoma NMSC. Methods: A systematic review of the literature pertaining to sunscreen efficacy in the primary prevention of melanoma and non-melanoma skin cancer, safety in humans and environmental impact was conducted. Following a thorough review of the literature, the Skin Cancer Prevention Working Group (SCPWG), an expert panel consisting of dermatologists with specialized training in melanoma and NMSC diagnosis and management, employed a modified Delphi technique to reach consensus over the development of statements regarding the current level of evidence for sunscreen efficacy and safety. Final statements were only adopted after achieving a supermajority vote &gt;80%. Results: 96 articles were identified for further review and discussion. The SCPWG developed 7 consensus statements regarding the efficacy and safety of sunscreens and their role in the prevention of melanoma and NMSC. Conclusion: The proven benefits of primary skin cancer prevention outweigh the potential/hypothetical risks of sunscreen use, especially given insufficient real-world, prospective data for the discussed risks. As experts in skin health and skin cancer pathophysiology, the SCPWG believes dermatologists are uniquely qualified to lead future studies investigating sunscreen efficacy and safety and should counsel patients and the public on skin cancer primary prevention strategies.