The U.S. Preventive Services Task Force has recommended that physicians counsel children, adolescents, and young adults on minimizing their ultraviolet radiation exposure to reduce their risk of skin cancer.
The recommendation was issued in draft form, which means that it is open for comment until Dec. 6. It was based on an evidence review published in February.
The USPTF focused on children and adults aged 10-24 years, grading the evidence supporting its recommendation as a B. Under that rubric, "there is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial."
However, the panel concluded that the evidence is "insufficient" to determine the risks and benefits of such counseling for adults.
The American Academy of Dermatology lauded the USPTF for its recommendation but took issue with its conclusion on adults. The AAD "is pleased that the USPSTF has recommended that sun protection counseling is important for children, adolescents, and young adults with fair skin types," said AAD President Ronald L. Moy. "However, the Academy believes sun protection counseling is important for everyone, including the adult population."
When the USPTF last looked at counseling, in 2003, it concluded there was insufficient evidence to support it for either children or adults.
In its update, however, the panel noted there being plenty of data showing that counseling is linked to behavior changes that lead to less sun exposure, at least in children. The USPTF also determined that there were no negative consequences to children being told to stay out of the sun. There was no decrease in outdoor activity or increase in body mass in the studies the panel reviewed. The studies did not assess the impact on vitamin D levels in children or adults.
The committee looked at studies on tanning bed use, also. There was not enough evidence to assess the association between use of tanning beds and the risk of squamous or basal cell carcinoma, reported the panel. A number of studies did, however, show an increased risk of melanoma with tanning beds.
Tanning beds are still an issue for the AAD, though.
"More than 3.5 million skin cancers in more than 2 million people are diagnosed annually, and excessive exposure to ultraviolet radiation from the sun and tanning beds is the most preventable cause of all skin cancers," said Dr. Moy.
The USPTF is funded by the Agency for Healthcare Quality and Research.