Effectiveness of topical sunscreen use to prevent skin cancers: systematic review

Luh Putu Venny Cempaka Sari

doi:10.18203/2320-6012.ijrms20213661

Authors

Luh Putu Venny Cempaka Sari Wangaya General Hospital, Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.18203/2320-6012.ijrms20213661

Keywords:

Sunscreen, Skin cancer, Melanoma, Squamous cell carcinoma, Basal cell carcinoma

Abstract

Topical sunscreen is a potential modality to prevent skin cancer development in vulnerable people although few study has evaluated its effectiveness in clinical setting. This study is aimed to review most recently available evidence on the clinical effectiveness of topical sunscreen in preventing skin cancers. We identified literature from online databases including Pubmed and Google Scholar and included population-based study evaluating the effect of sunscreen usage and risk of skin cancers, including melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC) either as primary objective or as a confounder in multivariate analysis. Data form included articles was harvested and analyzed with thematic analysis. Final analysis included 11 articles. Of these, 6 reported results on melanoma, 4 reported on BCC, and 3 on SCC. Overall, there was conflicting evidence on the effectiveness of topical sunscreen in preventing skin cancer. Available evidence found that topical sunscreen was most effective in preventing melanoma and SCC. However, there was considerable heterogenicity in study design and definition of sunscreen treatment between included articles that may affect the results. There are no consensus among included articles, including among RCTs, on the ideal topical sunscreen regiment to prevent skin cancer. There are conflicting evidence on the clinical effectiveness of topical sunscreen to prevent skin cancer although evidence suggest that it would be effective in preventing melanoma and SCC. More clinical studies should be conducted with special emphasis on ensuring subject apply the sunscreen correctly and consistently.

Metrics

Metrics Loading ...

References

Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Piñeros M, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer. 2019;144(8):1941-53.

D’Orazio J, Jarrett S, Amaro-Ortiz A, Scott T. UV radiation and the skin. Int J Mol Sci. 2013;14(6):12222-48.

Schneider SL, Lim HW. A review of inorganic UV filters zinc oxide and titanium dioxide. Photodermatol Photoimmunol Photomed. 2019;35(6):442-6.

Ailun H, Anqi L, Shiqin L, Jie T, Li L, Lidan X. Natural components in sunscreens: Topical formulations with sun protection factor (SPF). Biomed Pharmacother. 2021;134.

Olsen CM, Wilson LF, Green AC, Biswas N, Loyalka J, Whiteman DC. Prevention of DNA damage in human skin by topical sunscreens. Photodermatol Photoimmunol Photomed. 2017;33(3):135-42.

Ghiasvand R, Weiderpass E, Green AC, Lund E, Veierød MB. Sunscreen use and subsequent melanoma risk: A population-based cohort study. J Clin Oncol. 2016;34(33):3976-83.

Van Der Pols JC, Williams GM, Pandeya N, Logan V, Green AC. Prolonged prevention of squamous cell carcinoma of the skin by regular sunscreen use. Cancer Epidemiol Biomarkers Prev. 2006;15(12):2546-8.

Dyer RK, Weinstock MA, Cohen TSD, Rizzo AE, Bingham SF, Weinstock MA, et al. Predictors of basal cell carcinoma in high-risk patients in the VATTC (VA Topical Tretinoin Chemoprevention) trial. J Invest Dermatol. 2012;132(11):2544-51.

Green AC, Williams GM, Logan V, Strutton GM. Reduced melanoma after regular sunscreen use: Randomized trial follow-up. J Clin Oncol. 2011;29(3):257-63.

Lazovich D, Vogel RI, Berwick M, Weinstock MA, Warshaw EM, Anderson KE. Melanoma Risk in Relation to Use of Sunscreen or Other Sun Protection Methods. Cancer Epidemiol Biomarkers Prev. 2011;20(12):2583-93.

Youl P, Aitken J, Hayward N, Hogg D, Liu L, Lassam N, et al. Melanoma in adolescents: A case-control study of risk factors in Queensland, Australia. Int J Cancer. 2002;98(1):92-8.

Olsen CM, Thompson BS, Green AC, Neale RE, Whiteman DC, Webb PM, et al. Sun protection and skin examination practices in a setting of high ambient solar radiation: A population-based cohort study. JAMA Dermatology. 2015;151(9):982-90.

Luiz OC, Gianini RJ, Gonçalves FT, Francisco G, Festa-Neto C, Sanches JA, et al. Ethnicity and cutaneous melanoma in the city of Sao Paulo, Brazil: A case-control study. PLoS One. 2012;7(4):1-7.

Gon A, Minelli L. Risk factors for basal cell carcinoma in a southern Brazilian population: A case-control study. Int J Dermatol. 2011;50(10):1286-90.

Sánchez G, Nova J. Risk factors for squamous cell carcinoma, a study by the national dermatology. Actas Dermosifiliogr. 2013;104(8):672-8.

Ulrich C, Jürgensen JS, Degen A, Hackethal M, Ulrich M, Patel MJ, et al. Prevention of non-melanoma skin cancer in organ transplant patients by regular use of a sunscreen: A 24 months, prospective, case-control study. Br J Dermatol. 2009;161(3):78-84.

Diffey BL, Tanner PR, Matts PJ, Nash JF. In vitro assessment of the broad-spectrum ultraviolet protection of sunscreen products. J Am Acad Dermatol. 2000;43(6):1024-35.

Stanfield J, Osterwalder U, Herzog B. In vitro measurements of sunscreen protection. Photochem Photobiol Sci. 2010;9(4):489-94.

Bode AM, Roh E. Are FDA-Approved Sunscreen Components E ff ective. Cells. 2020;9(1674).

Kiviniemi MT, Ellis EM. Worry about Skin Cancer Mediates the Relation of Perceived Cancer Risk and Sunscreen Use. J Behav Med. 2014;37(6):1069-74.

Pichon LC, Corral I, Landrine H, Mayer JA, Adams-Simms D. Perceived skin cancer risk and sunscreen Use among African American adults. J Health Psychol. 2010;15(8):1181-9.

Jeanmougin M, Bouloc A, Schmutz JL. A new sunscreen application technique to protect more efficiently from ultraviolet radiation. Photodermatol Photoimmunol Photomed. 2014;30(6):323-31.

Zhou G, Zhang L, Knoll N, Schwarzer R. Facilitating Sunscreen Use Among Chinese Young Adults: Less-Motivated Persons Benefit from a Planning Intervention. Int J Behav Med. 2015;22(4):443-51.