Task Force: Tell young patients to stay out of sun

The group that sparked an outcry of criticism with its advice on mammograms and prostate cancer screening, said Monday that doctors should counsel young people to avoid sun exposure, to reduce the risk of skin cancer.

The advice applies to fair-haired people between the ages of 10 and 24, according to guidelines released Monday by the U.S. Preventive Services Task Force .  For adults older than 24, there is not enough evidence to say whether counseling about sun exposure makes a difference, according to the Task Force. The guidelines are published in the Annals of Internal Medicine.

With children younger than 10, counseling on sun exposure should be directed towards parents, said Dr. David Grossman, a member of the Task Force, a pediatrician and senior investigator at the Group Health Research Institute in Seattle. Patients age 10 to 24 should be told to wear sunscreen with an SPF of 15 or above, to cover exposed areas of skin, stay out of the sun between 10 a.m. and 3 p.m and to shun indoor tanning booths , Grossman said.

Some doctors say the advice doesn't go far enough.  "I would recommend counseling at younger ages," said Dr. Sophie Balk of Children's Hospital at Montefiore, in New York City. "We should start talking to parents as soon as babies are born, but as children get older and go out of the home, they should listen to the message, too."

Balk, the lead author of guidelines released by the American Academy of Pediatrics last year, also said the message should be broader. "The Task Force is telling us to focus on people with the lightest skin and eyes. Fair-skinned people are at highest risk, but everyone's at risk for skin cancer."

The Task Force is used to criticism . In 2009 its members took heat for saying that women in their 40s don’t need routine mammograms, and again last year for saying the PSA screening test for prostate cancer leads to more harm than good.

The last time it tackled the sun exposure issue, the Task Force said there was insufficient evidence to recommend counseling. To update its guidance, members examined existing studies on the impact of a doctor giving patients advice about sun exposure.  Almost all of those studies focus on fair-skinned patients younger than 24, Grossman said. “Our statement does not discourage counseling for older people,” he said, “but on a doctor visit you have a limited amount of time. Basically, we’re trying to point out where the greatest value seems to be.”

The American Cancer Society (ACS) praised the announcement as "important."

"They make the point that there's convincing evidence these conversations change the behavior," said Dr. Len Lichtenfeld, Deputy Chief Medical Officer of the ACS. "This is the age group that's most vulnerable, to getting sunburns, using tanning booths and increasing the risk of getting melanomas later in life."

Exposure during childhood to UV radiation from the sun is linked to a moderate increase in three types of skin cancer: Basal cell and squamous cell skin cancer, and melanoma. Skin cancer is the most common form of cancer in the United States, diagnosed in more than 2 million people a year. Melanoma is the least common but most deadly form of skin cancer, striking about 70,000 people last year and killing 8,800.