Application of sunscreen during childhood could reduce the risk of melanoma in adults

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This was a population-based, case-control study that investigated the role of sunscreen use during childhood in reducing the incidence of melanoma in adults. The cases were aged between 18 and 39 years and had received a diagnosis of first primary melanoma between July 2000 and December 2002. The cases were compared with one group of unrelated controls comprising of individuals selected from the electoral roll combined with nominated friends or spouses, and another group consisting of siblings of the cases. Information on sun exposure was self-reported. Participants also provided information about their demographics (e.g. education level), ethnicity, family history of melanoma, sunbed use and other risk factors in addition to self and parent reported sunscreen use.

The analysis included data for 603 cases and 1088 controls. The authors reported that the risk of melanoma was less with higher sunscreen use in childhood (odds ratio, OR: 0.60; 95% confidence interval, CI, 0.42-0.87) and use across a lifetime (OR, 0.65: 95% CI, 0.45-0.93). More specific analysis indicated that sunscreen use was more protective for people that reported they were prone to blistering sunburn, had some or many nevi and had received a diagnosis of melanoma at a younger age. There was no association with lifetime sun exposure and melanoma risk, however, when sun exposure unprotected by sunscreen was taken into account, it was reported that there was a significant risk of melanoma (OR, 1.80; 95% CI 1.22-2.65). This association was especially stronger for people with lighter pigmented skin or some or many nevi using sunscreen to stay out in the sun for longer.

Sub-optimal Application of a High SPF Sunscreen Prevents Epider-mal DNA Damage in Vivo

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The results of the study were able to demonstrate the protective effect of childhood sunscreen use in reducing the risk of melanoma. It was also able to identify personal risk factors for melanoma (skin colour, sun exposure behaviour). The study was limited in not being able to determine whether sunscreen was applied effectively. Also, sunscreen during the data period was commonly rated at SPF8 compared to the SPF30+ types in current use. However, it is possible that the higher SPF sunscreens would show a higher protective effect. Further, exposure to solar ultraviolet radiation was characterised by self-reported time in the sun. This limits reliability and introduces potential misclassification of the exposure data. The results strengthen the advice from both ARPANSA and Cancer Council that sunscreen use is an effective measure in preventing skin cancer.