Aim Skin Cancer Warnings at the Young, Too, Experts
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
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
"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.
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