Systematic Evidence Review to Update the 2003 U.S. Preventive Services Task Force Recommendation
Conclusions:
A limited number of RCTs suggest that primary care relevant behavioral counseling can minimally increase sun protection composite scores in adults and their newborns, decrease indoor tanning and objectively measured pigmentation in college students, and decrease midday sun exposure and increase sunscreen use in young adolescents. The clinical significance of small changes in sun protection composite scores is unclear. Many of the counseling interventions incorporated computerized support that could generate tailored feedback. Evidence, mostly from case-control studies, suggests that intermittent sun exposure, especially in childhood, is associated with an increase drisk for skin cancer. Regular sunscreen use can prevent squamous cell carcinoma, but it is unclear if it can prevent basal cell carcinoma or melanoma. Therefore, behavioral counseling to promote skin cancer prevention should focus on improving multiple behaviors to reduce UV exposure and not improving sunscreen use alone. There is some evidence to suggest that regular and early use of indoor tanning devices may increase the risk for melanoma. However, sunscreen and indoor tanning technologies have changed substantially over the past 20 to 30 years.