Sun protection counseling rates still low among pediatricians
By Megan Brooks
NEW YORK (Reuters Health) - More pediatricians are counseling their young patients about the importance of sun protection and the dangers of indoor tanning, but counseling rates still remain low, according to new research.
“Skin cancer is the most common cancer in the U.S. Overexposure to the sun and to artificial sources of ultraviolet radiation, especially in early life, raises skin cancer risk,” Dr. Sophie Balk from Children's Hospital at Montefiore, Albert Einstein College of Medicine, in the Bronx, New York, told Reuters Health.
“We know that clinician counseling can influence some people to protect themselves against UV radiation in order to decrease their chance of developing skin cancer. Counseling advice, therefore, is potentially life-saving,” she said by email.
The U.S. Preventive Services Task Force recommends counseling about minimizing sun exposure for fair-skinned individuals ages 10 to 24.
Using national surveys of American Academy of Pediatrics (AAP) members, Dr. Balk and colleagues compared pediatricians in 2002 with pediatricians in 2015 about their reported attitudes and counseling practices surrounding sun protection and indoor tanning. A total of 673 pediatricians (44% male) completed the 2002 survey, and 505 (30% male) completed the 2015 survey.
In each year, two-thirds of pediatricians reported treating at least one case of sunburn in the prior year, the researchers report in Pediatrics, online November 10.
In both years more than 90% “strongly agreed” that skin cancer is a significant public health problem, that indoor tanning raises skin cancer risk, and that pediatricians have a role in educating patients about sun protection and avoiding indoor tanning.
Significantly more pediatricians in 2015 than 2002 reported counseling most patients in every age group on sun protection (34% vs. 23%). “This is good news,” Dr. Balk said, “but only about a third of respondents in 2015 reported counseling most patients in each age group.”
Pediatricians in suburban areas were significantly more apt than those in inner-city areas to discuss sun protection (38% vs. 16%). Female pediatricians were significantly more likely to talk about sun protection than male pediatricians (31% vs. 24%). Location also mattered, with pediatricians in the South and West less likely to discuss sun protection than those in the Northeast.
Using sunscreen with SPF of at least 15 was the most commonly recommended sun protection measure in both surveys.
Rates of counseling preteens and teens on avoiding indoor tanning were also “relatively low and can be improved,” Dr. Balk said. In 2015, only 34% of pediatricians reported discussing the need to avoid indoor tanning at least once with patients age 10 to 13 years old, and roughly half discussed indoor tanning with older adolescents. (The 2002 survey did not ask about indoor tanning.)
In both surveys, pediatricians reported that the main barrier to counseling was lack of time.
The researchers write, “Further educational efforts by the AAP, skin cancer-prevention organizations, government agencies, and others that heighten awareness about adverse effects of early-life UVR exposure may serve to increase counseling. With better knowledge, more pediatricians may act on their key role in skin cancer prevention, potentially saving lives and avoiding the morbidities and treatment costs of nonfatal skin cancers.”
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