Behavioral Counseling to Prevent Skin Cancer: US Preventive Services Task Force Recommendation Statement

Area of Science:

• Dermatology
• Preventive Medicine
• Public Health

Background:

• Skin cancer is the most common cancer in the US, with melanoma causing the majority of deaths.
• Nonmelanoma skin cancers, basal cell carcinoma and squamous cell carcinoma, are the most prevalent types.
• The US Preventive Services Task Force (USPSTF) updated recommendations on skin cancer prevention and screening.

Purpose of the Study:

• To update the 2012 USPSTF recommendation on behavioral counseling for primary skin cancer prevention.
• To update the 2009 USPSTF recommendation on screening for skin cancer via skin self-examination.

Main Methods:

• Reviewed evidence on counseling for sun protection and its impact on intermediate outcomes and skin cancer incidence.
• Assessed the link between counseling, behavior change, and skin cancer.
• Evaluated the harms of counseling and changes in sun protection behavior.
• Examined evidence on counseling for skin self-examination and its impact on skin cancer outcomes and harms.

Main Results:

• Behavioral counseling moderately benefits sun protection behaviors in children, adolescents, and young adults (up to 24 years) with fair skin.
• Counseling provides a small increase in sun protection behaviors for adults over 24 with fair skin.
• Evidence is inadequate regarding the benefits and harms of counseling adults on skin self-examination for skin cancer prevention.

Conclusions:

• Counseling is recommended for individuals aged 6 months to 24 years with fair skin to minimize UV radiation exposure and reduce skin cancer risk.
• Clinicians should selectively offer counseling to adults over 24 with fair skin on minimizing UV exposure, considering individual risk factors.
• Insufficient evidence exists to assess the benefits and harms of counseling adults on skin self-examination for skin cancer prevention.