Sunscreen prevents skin cancer, yet doctors rarely recommend it

Sunscreen prevents skin cancer, yet doctors rarely recommend it
Doctors extolled the virtues of sunscreen in fewer than 1% of patient visits, a new study finds. (Francine Orr / Los Angeles Times)

Has your doctor ever advised you to use sunscreen? Chances are, the answer is no.

In fact, out of 18.3 billion doctor visits over nearly 21 years, sunscreen was recommended to patients only 12.83 million times, a new study finds. That works out to only 0.07% of visits.


OK, you're thinking, surely doctors did a better job when they were seeing patients for a skin-related disease like melanoma or actinic keratosis. And indeed, they were 12 times more likely to mention sunscreen to these patients. But that still added up to only 0.9% of doctor visits. That's right – less than 1%.

What's going on here? Are doctors not aware that sunscreen protects people from UV radiation, the damaging rays that are the primary cause of melanoma and other skin cancers?

Nope. The American Academy of Dermatology, the American Academy of Pediatrics, the American College of Gynecologists and the American Academy of Family Physicians all advise their members to counsel patients on protecting themselves from the sun. The Centers for Disease Control and Prevention and the American Cancer Society also endorse the practice.

And yet, when researchers from the Center for Dermatology Research at Wake Forest School of Medicine in North Carolina examined data from the CDC's National Ambulatory Medical Care Survey, they found that dermatologists mentioned sunscreen in only 1.6% of patient visits. When seeing patients with skin cancer or a history of the disease, sunscreen came up only 11.2% of the time. And dermatologists are the ones who are experts on keeping skin healthy.

Family medicine doctors and general practitioners discussed sunscreen only 0.03% of the time; internal medicine doctors did so 0.01% of the time; and pediatricians did so 0.01% of the time. All other doctors advised sunscreen use in 0.002% of patient visits.

One of the things that the researchers found most troubling was the fact that children (and their parents) were so rarely advised to use sunscreen. When they analyzed the data by age group, the researchers found that children under 10 were the least likely to be counseled about sunscreen use.

"Children and adolescents get the most sun exposure of any age group, as they tend to spend much of their time playing outdoors," the study authors noted in their report, published online Wednesday by JAMA Dermatology. "Up to 80% of sun damage is thought to occur before age 21 years, and sunburns in childhood greatly increase the risk for future melanoma."

Ironically, patients in their 70s were the most likely to discuss sunscreen with their doctors – the topic came up in 21.8% of patient visits, the study found. That's probably because patients in this age group often have visible signs of sun damage, the researchers found.

For those of us who aren't hearing it from our doctors, here's what the study authors recommend:

* Avoid the sun and stay in the shade, particularly from 10 a.m. to 4 p.m.

* Wear long-sleeved shirts, long pants and wide-brimmed hats.

* Avoid tanning beds and other sources of artificial UV light.

* And of course, use sunscreen. The Skin Cancer Foundation reminds us to put it on 30 minutes before going outside and to reapply it every two hours.

For more detailed information about the risk factors for skin cancer and what you can do to protect yourself, check out the CDC's "Protect Your Skin" website.


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