Over the past three decades, the global incidence of skin cancer has increased both for melanoma as well as for keratinocytic cancers (Basal Cell Carcinoma and Squamous Cell Carcinoma), and it is still rising worldwide (Beames et al., 2024; WHO, 2022).
Skin cancer is one of the most preventable types of cancer and it can be tackled through primary prevention measures (Del Marmol, 2022; Singh et al., 2024; WHO, 2022). The aim of primary prevention is to encourage behavioural changes which lead to preventing the exposure to known causal factors, such as ultraviolet radiation (UVR), and aims to lower the risk of developing subsequent skin cancer (Del Marmol, 2022).
Small amounts of UVR are beneficial to health and play an essential role in the production of vitamin D. However, excessive exposure to UVR is associated with negative health consequences as UVR is carcinogenic to humans (WHO, 2022). In fact, exposure to UVR is the main cause of skin cancer and it is estimated to be associated with 80-90% of skin cancers (Beames et al., 2024; Sander et al., 2020; WHO, 2022).
Who is at most risk?
According to WHO (2022), Caucasian populations are at a much higher risk of getting skin cancers because of their lack of skin pigmentation. Naturally brown and black people can usually safely tolerate relatively high levels of sun exposure without getting sunburnt or significantly increasing their skin cancer risk.
In addition, children and adolescents are particularly vulnerable to the harmful effects of UVR due to their skin and eye structure. Sunburn in childhood leads to a higher risk of skin cancer in later life.
There are also some individual risk factors that need to be taken into account:
- Fair skin.
- Blue, green or hazel eyes.
- Light-coloured hair
- Tendency to burn rather than suntan
- History of severe sunburns
- Many moles
- Freckles
- A family history of skin cancer.
Nevertheless, excessive exposure to intense sunlight can damage all skin types.
In order to prevent skin cancer, it is necessary for people to adopt protective measures and avoid exposure to UVR and, therefore, to the sun.
How to prevent skin cancer?
The WHO recommends the following measures:
- Limit time in the midday sun.
- Seek shade.
- Wear protective clothing.
- Wear a broad brimmed hat to protect eyes, face, ears and neck.
- Wear wraparound-style sunglasses that provide 99 to 100% UV-A and UV-B protection.
- Use broad-spectrum sunscreen on skin areas that cannot be covered by clothes. Sun protection is best achieved by seeking shade and wearing clothes rather than applying sunscreens. Sunscreens should not be used for extending time spent in the sun.
- Avoid use of artificial tanning devices.
The use of sunscreen has been shown to reduce the incidence of both melanoma and non-melanoma skin cancers. The American Academy of Dermatology recommends applying sunscreen with an SPF of 30 or higher regularly. Moreover, recent studies have shown that sunscreen remains on the skin at the desired SPF for as long as 8 hours after a single application, suggesting that historical advice to reapply sunscreen every 2-3 hours need not to be followed. However, reapplication is suggested when the likelihood of sunscreen having been removed is high, such as after sweating, water immersion, friction from clothing and exfoliation from sand. When swimming or sweating are anticipated, water-resistant sunscreens should be applied (Sander et al., 2020). However, the use of sunscreens in infants younger than 6 months is not recommended by Health Canada (Sander et al., 2020) because of the theoretical risk of higher body absorption of sunscreen ingredients. In this case, to protect infants from sun they recommend sun avoidance and protective clothing. Were it to be necessary to use sunscreen, experts suggest using a physical sunscreen and washing it off as soon as it is no longer required.
Sun protection is crucial in the prevention of skin cancer, especially during the summer months. Take care of yourselves and have a good summer!
REFERENCES:
Beames, C., Adelson, P., Sharplin, G., & Eckert, M. (2024). Primary care nurse’s role and educational preparedness in skin cancer screening and early detection: A scoping review. In Journal of Advanced Nursing (Vol. 80, Issue 6, pp. 2228–2251). John Wiley and Sons Inc. https://doi.org/10.1111/jan.15993
Del Marmol, V. (2022). Prevention and screening of melanoma in Europe: 20 years of the Euromelanoma campaign. Journal of the European Academy of Dermatology and Venereology, 36, 5–11.
Sander, M., Sander, M., Burbidge, T., & Beecker, J. (2020). The efficacy and safety of sunscreen use for the prevention of skin cancer. Cmaj, 192(50), E1802–E1808.
Singh, N., Dunlop, K. L. A., Woolley, N., Vashishtha, T. W., Damian, D. L., Vuong, K., Cust, A. E., & Smit, A. K. (2024). A review of skin cancer primary prevention activities in primary care settings. Public Health Research and Practice, 34(2). https://doi.org/10.17061/phrp34012401
WHO. (2022). https://www.who.int/news-room/fact-sheets/detail/ultraviolet-radiation.