Use Vanity to Reduce Young People's Sun Exposure: Task Force

Focusing on looks rather than skin cancer has more effect on youth, U.S. researchers find

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WEDNESDAY, Nov. 9 (HealthDay News) -- Doctors should appeal to young people's vanity to convince them to reduce their sun exposure, the U.S. Preventive Services Task Force says in draft recommendations released Wednesday.

For example, showing people ages 10 to 24 how too much sun exposure can affect their looks now and later in life can be much more effective than warning them they're at risk for skin cancer years from now, the task force said.

"We now have a reasonable level of evidence that we are able to change behavior in teens and young adults with a variety of counseling approaches that were appearance-based," task force Chair Virginia Moyer, a professor of pediatrics at Baylor College of Medicine in Texas, told the Wall Street Journal.

Other experts agreed.

"Young people are not concerned, for the most part, with their own mortality. The idea of 'cancer' seems miles away and not a consequence of their actions today," said Dr. Michele Green, a dermatologist at Lenox Hill Hospital in New York City. She finds this is true for tanning and other risky behaviors such as smoking and drinking.

"For skin cancer, if you can point out that they are prematurely aging or wrinkling, they are much quicker to respond and use sun precautions," Green added. "In today's world of beauty and glamour, there is such an importance in youth, that even young people know the value in our society of staying 'young looking.' "

Excess sun exposure in childhood is linked to a moderately higher risk of skin cancer later in life, and the new recommendations for fair-skinned people would update a 2003 statement from the task force.

Studies reviewed by the task force found that young people were more likely to recognize the hazards of sunbathing when shown sun-related changes on their faces through use of a UV camera or by looking at videos and booklets that depict sun-damaged skin. Half-hour counseling sessions also worked to change unhealthy tanning habits, including indoor tanning, which is particularly common among females.

Doctors hoping to dissuade young patients from tanning should choose whichever media form is most accessible, the task force said. Some computer programs "age" users, allowing them to see how they'll look years later.

Each year, more than two million Americans are diagnosed with skin cancer, the most common malignancy in the country. Most cases are basal cell, which is not associated with death, and squamous cell cancer, which accounts for a small percentage of all cancer deaths. Melanoma, which is deadlier, is expected to cause nearly 8,800 deaths this year, and incidence is increasing. Melanoma cases in the United States have tripled from 1975 to 2008, the task force noted.

All three types of skin cancer are associated with ultraviolet light exposure. To protect skin from harmful rays, skin specialists recommend wearing effective sunscreen, hats or other shade-protective clothing, staying out of the sun at midday, and avoiding indoor tanning.

"Severe sunburns, especially those early in life, are especially harmful to the skin," said Dr. Joshua Zeichner, director of cosmetic and clinical research in the dermatology department at Mount Sinai Hospital in New York City.

"Many types of skin cancers are largely preventable with proper sun protection," Zeichner added.
While the behavioral counseling approach worked best for the under-24 generation, there was no evidence it was effective for adults older than 24, the task force said.

But Green objected to that assessment.

"I emphatically disagree with the [task force] assertion that there is 'insufficient' evidence to assess the benefits of counseling patients over 24 years of age," she said. "I have been practicing for almost 20 years and I know the profound impact that education has made on most of my patients, their children and entire families.

"Skin cancer screening is a non-invasive 10-minute procedure which saves thousands of lives. What price can you put on saving your 16-year-old daughter from melanoma?" Green added.

Regular screenings are recommended to detect skin cancers. "If found early enough the majority of these skin cancers are curable," Zeichner said.

SOURCE: Michele Green, MD, dermatologist, Lenox Hill Hospital, New York City; Joshua Zeichner, MD, director, cosmetic and clinical research, department of dermatology, Mount Sinai Hospital, New York City; Nov. 9, 2011, U.S. Preventive Services Task Force, draft recommendation; Wall Street Journal

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