The US Preventive Services Task Force (USPSTF) has released a series of draft recommendations regarding clinical counseling for skin cancer prevention.
The task force concluded with moderate certainty that behavioral counseling interventions have a moderate net benefit in children, adolescents, and young adults aged 6 months to 24 years with fair skin, and for adults older than age 24 years with fair skin, behavioral counseling interventions have a small benefit. However, the task force stated that current evidence is insufficient to assess the balance of benefits and harms of counseling adults about skin self-examination.
The USPSTF made recommendations for three groups of individuals regarding skin cancer screening: fair-skinned persons aged 6 months to 24 years, fair-skinned adults older than age 24 years, and adults. The recommendations apply to asymptomatic persons without a history of skin cancer. Because most trials of skin cancer counseling predominantly include persons with a fair skin type, the USPSTF limited its recommendation to this population.
The task force recommends counseling for fair-skinned persons aged 6 months to 24 years and the parents of young children about minimizing exposure to ultraviolet (UV) radiation to reduce their risk of skin cancer (grade B recommendation).
In addition, the USPSTF recommends that clinicians selectively offer counseling to adults who have fair skin and are older than age 24 years 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 age 24 years is small (grade C).
In all adults, 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.
“A better understanding of the effectiveness of counseling on the use of sun protection behaviors in adults, including young adults, is needed to address the key evidence gap on counseling for this age group,” stated the task force. “Research that evaluates the association between UV exposure during adulthood and skin cancer risk would also be valuable. In addition, studies regarding the effectiveness of counseling persons without a fair skin type are lacking.”
This recommendation replaces the 2012 USPSTF recommendation on counseling about skin cancer prevention and the skin self-examination portion of the 2009 USPSTF recommendation on screening for skin cancer.
Draft Recommendation Statement: Skin Cancer Prevention: Behavioral Counseling. US Preventive Services Task Force. October 2017. Available at: https://www.uspreventiveservicestaskforce.org/Page/Document/draft-recommendation-statement/skin-cancer-counseling2#Pod8