US
Pharm. 2006;4:8.
It is fairly well known today that
sunburn at any age raises the risk of later developing melanoma, the deadliest
form of skin cancer. Older adults have the greatest risk of developing
melanoma. A recent study reviewing data on the American Academy of
Dermatology's National Skin Cancer Screening Program shows that middle-aged
and older men are the least likely to perform monthly skin self-examinations
or to regularly visit a dermatologist. This is part of the reason why men over
50 are the most likely group of individuals to die from malignant melanoma.
Pharmacists can impact the
health of their patients in this group. Widespread screenings could greatly
improve the cure rate since melanoma in its early stages is almost always
curable with surgical removal. Neglecting routine skin inspection (or,
combining the words, skinspection) makes people who develop melanoma
more vulnerable to advanced disease.
According to study authors,
"This increases their chances of having anundetected melanoma spread,
thereby requiring more radical treatment and lowering their odds of
survival." These findings help explain why men over age 50 have a
disproportionately high mortality rate from melanoma. More than 44% of the
screened subjects diagnosed with melanoma were men over age 50, though this
group comprised only 25% of those screened. Most of the melanomas discovered
were not yet invasive (in situ) or were slightly advanced (invasive). Without
screening, many of these melanomas might have remained undetected until
seriously advanced.
Conducting the largest
case-control study to investigate the different impact of childhood and
adulthood sun exposure on melanoma development, scientists recently found that
having several sunburns over the course of a lifetime can double or triple
melanoma risk, no matter when the sunburns occur. More than five lifetime
sunburns translated to twice the risk; more than 15 translated to three times
the risk. The lead researcher concluded that programs designed to educate the
public about sun protection should not focus only on younger age groups or
parents with young children, but should target the entire population.
Clearly, more emphasis on
protecting our skin is warranted. The Skin Cancer Foundation is an excellent
resource for information about skin cancer prevention and recognition (see
www.skincancer.org). Talk about sunburn and skinspection with your patients.
If they have poor eyesight or another obstacle to performing a
self-examination and have been sunburned in the past, it may be prudent to
refer them to a dermatologist.
This month's editorial focus
is dermatologic disorders. From minor wound care to recognizing melanoma,
pharmacists offer valuable advice to patients every day.
Laura La Piana Simonsen
Executive Managing Editor
To comment on this article, contact editor@uspharmacist.com.
