Sun protection; Less than half of health care providers discuss sun-safe behaviors with patients, according to a study published in the September issue of Preventive Medicine. Dawn M. Holman, M.P.H., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues used data from the 2016 DocStyles, a web-based survey of U.S. primary care providers; to evaluate skin cancer prevention counseling practices among 1,506 providers.
Each year in the United States, nearly 5 million adults are treated for skin cancer with a corresponding $8.1 billion spent on treatment. Most skin cancer cases are understood to be caused by exposure to ultraviolet radiation (UVR) from the sun or from indoor tanning devices (Armstrong and Kricker, 2001). Individuals with fair skin, light hair, light eyes, skin that burns or freckles; certain types or a large number of moles, and a personal or family history of skin cancer tend to be more susceptible to the carcinogenic effects of UVR exposure.
Combination of sun protection
Recommendations to reduce skin cancer risk include using a combination; so of sun protection strategies when outdoors, minimizing time outdoors during midday when the sun’s rays are most intense; also avoiding intentional sun tanning and indoor tanning. The objective of the current study was to examine the reported skin cancer prevention counseling practices of U.S. health care providers and factors associated with regular counseling.
This study builds on previous work led by the American Academy of Pediatrics (AAP) which used data from a 2015 survey of AAP members to assess their counseling practices about use of sun protection and avoidance of indoor tanning. The study findings revealed that the percentage of pediatricians who report discussing sun protection with at least 75% of their patients during the most recent summer months ranged from 45% for patients aged ≥14 years to 51% for patients aged 7 months 2 years.
Furthermore, about one-third reported discussing indoor tanning at least once with 10 to 13 year old patient; also approximately half discuss this topic with older adolescents. In the current study, they examine counseling practices; also barriers to counseling among pediatricians, family practitioners, internists, and nurse practitioners.
Counseling on indoor tanning
The researchers found that almost half (48.5%) of all providers report regularly counseling on sun protection; with 27.4% reporting regularly counseling on indoor tanning. Regular counseling was more common among providers who had practice medicine for at least 16 years; who had treat sunburn in the previous year (sun protection: aPR, 1.78; indoor tanning: aPR, 2.42); also had awareness of U.S. Preventive Services Task Force recommendations (sun protection: aPR, 1.73; indoor tanning: aPR, 2.70).
There was a lower likelihood of regularly counseling on sun protection and indoor tanning for providers reporting barriers to counseling (sun protection: one to three barriers, aPR, 0.82; at least four barriers, aPR, 0.80; indoor tanning: one to three barriers, aPR, 0.72; at least four barriers, aPR, 0.61). Lack of time (58.1%), more urgent health concerns (49.1%), and patient disinterest (46.3%) were the most commonly reported barriers to counseling.
Many health care providers report regularly counseling patients on the use of sun protection and indoor tanning avoidance; also opportunities exist to support and possibly increase these counseling practices.Efforts to encourage clinical counseling could include information about the wide array of sun safety strategies that clinicians could promote among their patients; also encourage clinicians to consider other patient characteristics beyond age and skin tone; such as the patient’s history of sunburn family history of skin cancer; when deciding whether to provide clinical counseling.