Sunscreen and Melanoma: Is Our Prevention Message Correct?

Planta, Margaret B

doi:10.3122/jabfm.2011.06.100178

Cited by 31 publications

(32 citation statements)

References 33 publications

(62 reference statements)

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“…Results of the univariable analyses indicated that greater acculturation among U.S. Hispanics is linked with both risky (i.e., not wearing sun protective clothing) and protective sun-related practices (i.e., using sunscreen). While there is some epidemiological research linking such behavioral practices with the risk for melanoma, there is more consistent evidence regarding the role that sunburns play as a risk factor for melanoma [29]. We found that around half of the more acculturated Hispanics reported having a sunburn in the past year, which is considerably higher than the approximately one in three rate among less acculturated individuals.…”

Section: Discussionmentioning

confidence: 58%

“…We found that around half of the more acculturated Hispanics reported having a sunburn in the past year, which is considerably higher than the approximately one in three rate among less acculturated individuals. While sunscreen use is commonly endorsed by the public and also depicted in the media [30,31], other sun protection behaviors such as staying out of the sun and using sun protective clothing may be more effective in reducing sunburns and the risk for melanoma [28,29,32]. These non-sunscreen behaviors should be strongly emphasized by healthcare providers and in public health initiatives to prevent skin cancer, particularly when targeting more acculturated, English-speaking Hispanics.…”

Section: Discussionmentioning

confidence: 99%

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Sun protection and exposure behaviors among Hispanic adults in the United States: differences according to acculturation and among Hispanic subgroups

et al. 2012

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BackgroundSkin cancer prevention interventions that target the growing number of U.S. Hispanics are lacking. The current study examined the prevalence and correlates of sun protection and exposure behaviors (i.e., sunscreen use, shade seeking, use of sun protective clothing, and sunburns) among U.S. Hispanics with sun sensitive skin, with a focus on potential differences according to acculturation and Hispanic origin.MethodsThe sample consisted of 1676 Hispanic adults who reported having sun sensitive skin (i.e., they would experience a sunburn if they went out in the sun for one hour without protection after several months of not being in the sun). Participants completed survey questions as part of the nationally representative 2010 National Health Interview Survey. Analyses were conducted in August 2012.ResultsGreater acculturation was linked with both risky (i.e., not wearing sun protective clothing) and protective (i.e., using sunscreen) sun-related practices and with an increased risk of sunburns. Sun protection and exposure behaviors also varied according to individuals’ Hispanic origin, with for example individuals of Mexican heritage having a higher rate of using sun protective clothing and experiencing sunburns than several other subgroups.ConclusionsSeveral Hispanic subpopulations (e.g., those who are more acculturated or from certain origins) represent important groups to target in skin cancer prevention interventions. Future research is needed to test culturally relevant, tailored interventions to promote sun protection behaviors among U.S. Hispanics. Such initiatives should focus on public health education and increasing healthcare provider awareness of the importance of skin cancer prevention among Hispanics.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Sun protection and exposure behaviors among Hispanic adults in the United States: differences according to acculturation and among Hispanic subgroups

et al. 2012

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“…Furthermore, the molecular basis for UV-mediated transformation of melanocytes to melanomas is also not fully understood (15–17). Moreover results of recent trials evaluating whether limiting or blocking sun exposure to reduce melanoma incidence and mortality rates are confusing and not encouraging (18–21). Therefore chemoprevention of melanoma remains a challenge to the scientific community.…”

Section: Introductionmentioning

confidence: 99%

Chemoprevention of Melanoma

Madhunapantula

Robertson

2012

Advances in Pharmacology

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Despite advances in drug discovery programs and molecular approaches for identifying the drug targets, incidence and mortality rates due to melanoma continues to rise at an alarming rate. Existing preventive strategies generally involve mole screening followed by surgical removal of the benign nevi and abnormal moles. However, due to lack of effective programs for screening and disease recurrence after surgical resection there is a need for better chemopreventive agents. Although sunscreens have been used extensively for protecting from UV-induced skin cancer, results of correlative population based studies are controversial, requiring further authentication to conclusively confirm the chemoprotective efficacy of sunscreens. Certain studies suggest increased skin-cancer rates in sunscreen users. Therefore, effective chemopreventive agents for preventing melanoma are urgently required. This book-chapter, reviews the current understanding regarding melanoma chemoprevention and the various strategies used to accomplish this objective.

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“…With a discriminating eye for the literature, Planta 16 reviewed the evidence for the use of sunscreens to prevent malignant melanoma, particularly beyond a specific latitude. She found the extant literature wanting, with better evidence to encourage prevention of sun burns than generalized recommendations for sunscreen use, which for most patients is intermittent at best.…”

Section: Other Topicsmentioning

confidence: 99%

Change, Lack of Change, and Creating Optimal Change Out of Chaos

Bowman¹,

Neale²

2011

The Journal of the American Board of Family Medicine

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Once again, we consider how to effect practice change at the local and national levels. This issue includes several articles that relate to quality improvement. Some physician actions seem resistant to change, as do the underlying social determinants and processes that lead to what are thought to be avoidable hospitalizations, but we also find that concerted effort, along with standardized orders sets and other avenues, can make a difference. Sometimes, however, our attempts at change can lead to more distraction then efficacy. Here we include articles that place the quality issues in context, report interventions, and advance the types of specific knowledge that allow interventional trials. We also have several articles about cancer screening and follow-up, a subset of quality improvement. Quality ImprovementBaird 1 provides us with a fascinating historic and nuanced reflection of how and whether medical homes represent something new or otherwise different from former attempts at reform in family medicine, specifically managed care. In light of previous inflated expectations of the ways in which reforms can change medical care, he says, "no villains allowed."Information chaos is clearly one of the reasons that we struggle to improve quality to a desired level. Beasley and colleagues 2 provide a structure to consider the information chaos, the negative outcomes of the chaos, and some direction for future research. This construct also relates to our tonguein-cheek, yet provocative, selection from Baxley et al.3 who suggests that we sometimes act as if we have attention deficit disorder as we attempt to implement multiple concurrent Plan-Do-StudyAct practice improvement projects. It is a variant of a "quality improvement disorder." Therefore, some remedies are in order. However, the answer is not to just take a pill daily and hope it will go away. Hopefully, we can improve the quality of our quality improvement activities.In one major attempt to improve health care nationally, the Affordable Care Act mandates that the Centers for Medicaid and Medicare Services (CMS) implement a 10% payment increase for primary care. CMS criteria defining primary care are unfortunately currently inadequate to the task because they exclude many family physicians, particularly those in more rural settings or those who provide a broader range of services, as documented by research from the Robert Graham Center. 4 On to specific examples from the articles in this issue. We know that preventable hospitalizations vary by location, but just how easy are these to avert? Sumner et al 5 determined that the differences in preventable hospitalizations between the counties in Kentucky persisted over time. This suggests that underlying problems or processes are not readily changed, and that needed health care improvements will be relatively resistant to transformation.Another specific quality improvement item that seems resistant to change is the ordering of urine cultures for women with urinary tract infection symptoms. Obtaining urine culture...

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Sunscreen and Melanoma: Is Our Prevention Message Correct?

Cited by 31 publications

References 33 publications

Sun protection and exposure behaviors among Hispanic adults in the United States: differences according to acculturation and among Hispanic subgroups

Sun protection and exposure behaviors among Hispanic adults in the United States: differences according to acculturation and among Hispanic subgroups

Chemoprevention of Melanoma

Change, Lack of Change, and Creating Optimal Change Out of Chaos

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