Did New USPSTF Recommendations on Skin Cancer Prevention Counseling Go Far Enough? AADA Reacts

The U.S. Preventive Services Task Force (USPSTF) is calling for behavioral counseling to help reduce the risk of skin cancer from ultraviolet (UV) radiation in people aged 6 months to 24 years with fair skin types.

The new USPSTF recommendation statement updates a 2012 recommendation on behavioral counseling to prevent skin cancer and a 2009 recommendation on screening for skin cancer with self-examinations.

But some groups including the American Academy of Dermatology Association (AADA) are concerned that they didn’t go far enough.

“We want to stress, however, that skin cancer prevention is important for people of all ages and skin types, not just those with fair skin between the ages of 6 months and 24 years,” says AADA President Suzanne M. Olbricht, MD, FAAD. “The AADA recommends that everyone, regardless of age or skin type, stay out of indoor tanning beds, and protect themselves from the sun’s harmful UV rays by seeking shade, wearing protective clothing and using a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher. While this is important for young people to reduce their risk of skin cancer in the future, these behaviors should continue throughout life.”

The USPSTF also recommends that clinicians selectively offer counseling to adults older than 24 years with fair skin types about minimizing their exposure to UV radiation to reduce risk of skin cancer. Existing evidence indicates that the net benefit of counseling all adults older than 24 years is small. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the presence of risk factors for skin cancer. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of counseling adults about skin self-examination to prevent skin cancer.

“The AADA is disappointed that the USPSTF found insufficient evidence to recommend counseling on skin self-exams,” Dr. Olbricht says.