Sunscreen Use and Melanoma Risk Among Young Australian Adults

Abstract

IMPORTANCE There are limited data among young adults on sunscreen use during childhood and adulthood and on the association of sunscreen use with melanoma risk. OBJECTIVE To assess correlates of early-life sunscreen use and the association between sunscreen use and risk of cutaneous melanoma before age 40 years. DESIGN, SETTING, AND PARTICIPANTS This population-based, case-control family study analyzed Australian Melanoma Family Study data for persons with questionnaire data on sunscreen use collected by interview from 2001 to 2005 across 3 states in Australia, representing two-thirds of the country's population. Case participants (aged 18-39 years) had confirmed first primary melanoma. Siblings of case participants were included, and case participants without a sibling control were excluded. Unrelated controls (aged 18-44 years) were recruited from the electoral roll or were a spouse, partner, or friend nominated by case participants. Data analyses were conducted from October 2017 to February 2018. EXPOSURES Self-and parent-reported sunscreen use, sun exposure, and other candidate risk factors during childhood and adulthood. MAIN OUTCOMES AND MEASURES Logistic regression analyses adjusted for potential confounders were used to estimate odds ratios (ORs) for melanoma and for correlates of sunscreen use. RESULTS Participation was 629 of 830 contactable cases (76%) (629 of 1197 overall [53%]), 240 of 570 contactable controls (42%) from the electoral roll (240 of 1068 overall [23%]), and 295 of 371 nominated spouse or friend controls (80%); analysis incuded 603 cases and 1088 controls. The median (interquartile range) age was 32 (28-36) years for 603 cases, 35 (30-38) years for 478 unrelated controls, and 34 (29-38) years for 610 sibling controls. There were more women than men (range, 57%-62%) in all groups, approximately 40% (range, 39%-43%) of participants had a university education, and most participants (range, 58%-73%) had British/northern European ethnicity. Risk of melanoma was less with higher use of sunscreen in childhood (OR for highest vs lowest tertiles, 0.60; 95% CI, 0.42-0.87; P = .02 for trend) and across the lifetime (OR, 0.65; 95% CI, 0.45-0.93; P = .07 for trend). Subgroup analyses suggested that the protective association of sunscreen with melanoma was stronger for people reporting blistering sunburn, receiving a diagnosis of melanoma at a younger age, or having some or many nevi. Total lifetime sun exposure was unrelated to melanoma risk (OR for highest vs lowest tertile, 0.97; 95% CI, 0.66-1.43; P = .94 for trend). By contrast, total sun exposure inversely weighted by sunscreen use (as a measure of sun exposure unprotected by sunscreen) was significantly associated with melanoma risk (OR, 1.80; 95% CI, 1.22-2.65; P = .007 for trend) and appeared stronger for people having lighter pigmentation or some or many nevi or using sunscreen to stay longer in the sun. Regular users of sunscreen were more likely to be female, younger, and of British or northern European ancestry and to have higher educati...

Pharmacodynamic Modeling of Sunscreens: Efficacy Evaluation, Melanoma Incidences and Very Low to Very High Sun Protection Factor

“…where the whole population is exposed to high ambient radiation [10,15]. It appears that the benefits from daily non-intentional use of sunscreens should also be attainable for those people residing in temperate climates.…”

“…On the other hand, SPF 8 sunscreen was reported to be effective against melanoma in Australia in a 2018 study [15]. It appears that to date potential reasons of the apparent difference in conclusion between these two studies [13,15] have not been considered. In a highly respected commentary published in 2019 [14], it was stated that "The effect of sunscreen on melanoma prevention is also unclear ".…”

“…population-based cohort study in Norway [13]. On the other hand, SPF 8 sunscreen was reported to be effective against melanoma in Australia in a 2018 study [15]. It appears that to date potential reasons of the apparent difference in conclusion between these two studies [13,15] have not been considered.…”

Knowledge and health behaviours connected with melanoma prevention among people living in Poland and Australia

“…Generally available protection against UV radiation consists of wearing sun-protective clothing, wide-brimmed hats, and sunglasses [11,12]. It also involves application of sunscreen lotions that contain filters blocking UVB and UVA radiation [13][14][15]. Effective prevention of melanoma and skin cancer means also spreading knowledge about health hazards connected with indoor tanning (tanning salons), which are dangerous especially for teenagers [16,17].…”

Machine learning for the prediction of sunscreen sun protection factor and protection grade of UVA

“…Overexposure to ultraviolet (UV) light can lead to harmful clinical consequences such as photo‐ageing and skin cancer, mostly due to UV rays, including UVA (320‐400 nm) and UVB (280‐320 nm) . Sunscreens play a crucial role in reducing the risk of melanoma and photo‐ageing by absorbing UV rays . Sunscreens are labelled with sun protection factor (SPF) and protection grade of UVA (PA) levels according to their ability to protect against UVB and UVA, respectively.…”