The Skin Cancer Foundation Journal

MAY 2012

The 2012 edition of The Skin Cancer Foundation Journal features medically reviewed, reader-friendly articles such as tanning, the increasing incidence of skin cancer diagnoses among young women, & the prevalence of melanoma among white males over 50.

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Page 42 of 103

Sunscreen Cuts Melanoma Risk in Half How Breakthrough Research Provided First Direct Evidence ADELE C. GREEN, MD I n December 2010, researchers led by Adele C. Green, MD, published a landmark study showing that regular sunscreen users have half the risk of developing melanoma compared to non-users. Published in the Journal of Clinical Oncology, the study was the fi rst to provide strong direct evidence that sunscreen helps prevent melanoma, which will kill an estimated 9,180 people in the US in 2012. While some previous studies had pointed to the protective benefi ts of sunscreen, they had been either lab studies or retrospective studies rely- ing on the subjects' memories of their past sunscreen use — less than ideal forms of research. Dr. Green's results were the fi rst ever to emerge from a prospective, randomized clinical trial, considered a superior research method, where a control group of untreated subjects is compared against a group of treated subjects. Scientists had been hesitant to undertake such research in the past because it would mean exposing the control group to danger- ous amounts of harmful ultraviolet (UV) radiation. However, Dr. Green's "Intervening in people's lives is naturally more challenging than simply observing people…" Dr. Green and colleagues had also published previous research showing that sunscreen helps pre- vent squamous cell carcinoma, a common form of skin cancer that can also be deadly. The Skin Cancer Foundation's Executive Editor Mark Teich interviewed Dr. Green about the signifi cance of her team's fi ndings. team found an ingenious way around this problem. More than 1,600 white Australian adults between ages 25 and 65 were followed for a decade and a half. The subjects were divided into two groups, the control group asked to continue using (or not using) sunscreen as they always had, the other given careful instruction and supervision in daily sunscreen application. The subjects reported on their sunscreen use; researchers also collected and weighed all the sunscreen containers used. The results? Only 11 melanomas developed among the daily sunscreen users, versus 22 in the control group. Q: With your series of studies on sunscreen and skin cancer, how defi nitive would you say it is now that sunscreen can help prevent squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and melanoma, the three most common skin cancers? A: The most solid proof is for squa- mous cell carcinoma (SCC). There is strong and consistent evidence that SCC and actinic keratosis (the most common skin precancer) are decreased by regular sunscreen use. Then there is the evidence from our melanoma study. It was a random- ized controlled trial [a scientifi cally controlled study on a therapy's ef- fectiveness], and therefore fairly solid, but it is just one study, so it remains 41

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