Skin cancers are the most frequent cancers in fair-skinned populations, but we can prevent them.
Eur J Cancer. 2024 Jun;204:114074. doi: 10.1016/j.ejca.2024.114074. Epub 2024 Apr 24. PMID: 38691877.
Garbe C, Forsea AM, Amaral T, Arenberger P, Autier P, Berwick M, Boonen B, Bylaite M, Del Marmol V, Dreno B, Fargnoli MC, Geller AC, Green AC, Greinert R, Hauschild A, Harwood CA, Hoorens I, Kandolf L, Kaufmann R, Kelleners-Smeets N, Lallas A, Lebbé C, Leiter U, Lim HW, Longo C, Malvehy J, Moreno D, Pellacani G, Peris K, Robert C, Saiag P, Schadendorf D, Peter Soyer H, Stockfleth E, Stratigos A, Uhara H, Vieira R, Volkmer B, Weinstock MA, Whitaker D, Zalaudek I, Whiteman DC, Brochez L.
Cancers of the skin are the most commonly occurring cancers in humans. In fair-skinned populations, up to 95% of keratinocyte skin cancers and 70-95% of cutaneous melanomas are caused by ultraviolet radiation and are thus theoretically preventable. Currently, however, there is no comprehensive global advice on practical steps to be taken to reduce the toll of skin cancer. To address this gap, an expert working group comprising clinicians and researchers from Africa, America, Asia, Australia, and Europe, together with learned societies (European Association of Dermato-Oncology, Euromelanoma, Euroskin, European Union of Medical Specialists, and the Melanoma World Society) reviewed the extant evidence and issued the following evidence-based recommendations for photoprotection as a strategy to prevent skin cancer. Fair skinned people, especially children, should minimise their exposure to ultraviolet radiation, and are advised to use protective measures when the UV index is forecast to reach 3 or higher. Protective measures include a combination of seeking shade, physical protection (e.g. clothing, hat, sunglasses), and applying broad-spectrum, SPF 30 + sunscreens to uncovered skin. Intentional exposure to solar ultraviolet radiation for the purpose of sunbathing and tanning is considered an unhealthy behaviour and should be avoided. Similarly, use of solaria and other artificial sources of ultraviolet radiation to encourage tanning should be strongly discouraged, through regulation if necessary. Primary prevention of skin cancer has a positive return on investment. We encourage policymakers to communicate these messages to the general public and promote their wider implementation.
Table 1 Advice for ultraviolet radiation protection for fair skinned populations.
•Avoid sunbathing and tanning |
•Do not use sunbeds |
•Use UV protection measures when UV index is moderate or higher:•Use clothing, a wide-brimmed hat and sunglasses as the main protection measures;•Use a sunscreen with sun protection factor 30 + – 50 + and UVA label for all skin areas that cannot be protected by clothing;•Avoid direct sun exposure at solar noon (2 h before / after). |
Fig. 2 Ultraviolet Radiation Index-dependent recommendation of photoprotection Adapted from WHO
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