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Counsel young people to avoid skin cancer, says US

Advise fair-skinned six month to 24 year olds, and adults, to minimise exposure to UV radiation

Louise Prime

Wednesday, 21 March 2018

Doctors should offer behavioural counselling about minimising exposure to ultraviolet (UV) radiation to help reduce the risk of skin cancer in fair-skinned people aged six months to 24 years, according to a US task force whose recommendation* is published today in JAMA. In its latest recommendation it also noted that there is currently insufficient evidence regarding the relative benefits and risks of advising adults to conduct self-examination to prevent skin cancer.

The US Preventive Services Task Force (USPSTF), which makes many recommendations about the effectiveness of preventive care services, pointed out that skin cancer is the most common type of cancer in the US, where there were an estimated 3.3 million new cases of non-melanoma skin cancer in 2012 and approximately 90,000 new cases of melanoma skin cancer in 2018.

The new recommendation is an update to statements made by the USPSTF in its 2012 recommendation on behavioural counselling to prevent skin cancer, and 2009 recommendation on screening for skin cancer with self-examinations. The previous recommendation applied to persons aged 10 to 24 years, based on the evidence available at that time. USPSTF now recommends (B recommendation) counselling young adults, adolescents, children, and parents of young children about minimising exposure to UV radiation for persons aged six months to 24 years with fair skin types to reduce their risk of skin cancer.

Furthermore, USPSTF recommends (C recommendation) that clinicians should selectively offer counselling to adults older than 24 years with fair skin types about minimising their exposure to UV radiation to reduce the risk of skin cancer. The task force said the existing evidence indicates that the net benefit of counselling all adults older than 24 years is small. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the presence of risk factors for skin cancer.

Finally, the task force concludes (I statement) that the current evidence is insufficient to assess the balance of benefits and harms of counselling adults about skin self-examination to prevent skin cancer.


*Grossman DC, Curry SJ, Owen DK, et al. Behavioral counselling to prevent skin cancer: US Preventive Services Task Force Recommendation Statement. JAMA 2018; 319(11): 1134–1142; doi:10.1001/jama.2018.1623.

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