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Regular sunscreen use lowers melanoma risk among young adults

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August 2, 2018

Regular use of sunscreen appeared associated with a reduced risk for melanoma among young adults in Australia, according to findings published in JAMA Dermatology.

“The association of sun exposure and sunburn, particularly in childhood, with melanoma risk is well established,” Caroline G. Watts, MPH, PhD, researcher at Sydney School of Public Health of University of Sydney, and colleagues wrote. “Despite sunscreen being widely available and recommended for sun protection, optimizing the use of sunscreens remains a challenge, and controversies continue to surround its use.

“No studies have specifically examined the association between use of sunscreen in childhood and early adulthood and risk of melanoma before 40 years of age or investigated the factors associated with sunscreen use in childhood and early adulthood,” they added.

Watts and colleagues performed a population-based, case-control family study of patients with melanoma aged 18 to 39 years from the Australian Melanoma Family Study. All patients had available questionnaire data collected via interview in three Australian states from 2001 to 2005. The sample represented two-thirds of the national population. The researchers included the siblings of case participants, and patients who did not have siblings were excluded from the analysis. Unrelated controls, all aged 18 to 44 years, included spouses, partners or friends of case participants, as well as controls recruited from electoral rolls.

Overall, the analysis included 603 case participants (median age, 32 years) and 1,088 controls (unrelated, n = 478; median age, 35 years; siblings, n = 610; median age, 34 years). All groups comprised more women than men (range, 57% to 62%).

Roughly 40% (range, 39% to 43%) of participants had a college education, and most (range, 58% to 73%) were of British or northern European ethnicity.

ORs for melanoma and correlates with sunscreen use served as the main study measures.

Greater sunscreen usage in childhood was associated with a lower risk for melanoma (OR for highest vs. lowest tertiles = 0.6; 95% CI, 0.42-0.87). This association persisted with greater use across participants’ lifetimes (OR = 0.65; 95% CI, 0.45-0.93).

The protective association between sunscreen and melanoma appeared stronger among participants who reported blistering sunburn, those who were diagnosed with melanoma at a younger age, and those who had some or many nevi.

Total sun exposure over the course of a lifetime was not associated with melanoma (OR for highest vs. lowest tertile = 0.97; 95% CI, 0.66-1.43), although total sun exposure when weighted to account for exposure without sunscreen was significantly associated with risk for melanoma (OR = 1.8; 95% CI, 1.22-2.65). This association appeared stronger among participants who had lighter skin pigmentation, who had some or many nevi, or who used sunscreen to spend more time in the sun.


Regular sunscreen used appeared more common among women, as well as those who were younger or who had had lighter skin, a higher level of education and a history of blistering sunburn.

“Our results support the regular use of sunscreen to reduce the risk of melanoma in early adulthood and emphasize the need to reach all population subgroups with sun protection messages,” the researchers wrote. –by Andy Polhamus

Disclosures: The authors report no relevant financial disclosures.

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In JAMA Dermatology, Watts and colleagues use a novel approach to evaluate sunscreen use as a youth and the association with melanoma among patients aged younger than 40 years. This study is the first of its kind looking at melanoma in this age group. Using the Australian Melanoma Family Study — a population study — researchers evaluated patients with melanoma who they compared with an unrelated control group, as well as with siblings of case participants. Researchers evaluated many variables related to skin cancer, sun exposure and sunscreen use between the groups.

Overall, results showed risk for melanoma appeared significantly less among participants who had a higher use of sunscreen in their childhood. Sunscreen appeared more protective against melanoma among patients who had at least one blistering sunburn, were diagnosed with melanoma at a young age or had many moles. Those participants found to use sunscreen regularly were more commonly female, younger, or of British or Northern European ancestry, and they had a higher education level, lighter skin pigmentation and history of blistering sunburn.

This is a very interesting study comparing higher- and lower-risks groups, specifically aiming to show evidence that regular sunscreen used decreased the risk for melanoma among young adults. Studying sunscreen and its benefit in reducing skin cancer has historically been very hard for researchers to prove, due to the variability and difficulty in quantifying sun exposure and overall sunscreen use. This study proved to be successful in comparing a specific age group and researchers did a great job utilizing their specific groups to demonstrate that regular use of sunscreen in early childhood or youth was associated with a lower chance of melanoma.

Jeffrey M. Farma, MD, FACS

Fox Chase Cancer Center

Disclosure: Farma reports no relevant financial disclosures.