Counsel young patients about skin cancer prevention

Young patients with fair skin should be counseled about reducing their exposure to ultraviolet radiation to reduce the risk of skin cancer, according to a new recommendation statement from the U.S. Preventive Services Task Force (USPSTF).

The statement was based on a targeted literature search for new evidence on sun protection and skin cancer. Based on the results, the USPSTF recommended that primary care clinicians counsel fair-skinned patients age 10 to 24 years about protecting themselves from the sun. This group was targeted because most trials of skin cancer counseling only include people with fair skin, and more evidence of counseling's effectiveness is available in this population than in older or younger patients.

For patients older than 24, the USPSTF concluded that the evidence is insufficient to assess the benefits and harms of counseling about preventing skin cancer. It's unknown whether counseling changes these patients' behavior and there is less clear evidence that behavior change would reduce their risk for skin cancer, the statement said.

For counseling younger patients, the most effective interventions focused their messages on cancer prevention or appearance. Appearance-focused intervention included self-guided booklets, videos on photoaging, peer counseling sessions, and ultraviolet facial photography to demonstrate the patient's existing skin damage. The USPSTF statement noted that none of these interventions are associated with any known risks or harms.

The statement replaced the USPSTF's 2003 recommendation, which found insufficient evidence on skin cancer counseling at any age. This new review found significant studies conducted in young persons describing a consistent picture of moderate behavior change, the task force noted. The statement was published online by Annals of Internal Medicine on May 8.