Intentional and careless exposure to solar radiation or artificial sources of UV radiation to tan “is an unhealthy behavior and should be avoided. It is the main ‘driver’ of the onset of skin cancers”. These are the conclusions of the recommendations drawn up by experts from 5 continents and international scientific societies and published in the ‘European Journal of Cancer’. It is the first global consensus of experts on the prevention of skin cancer and correct photoprotection based on scientific evidence. According to Sidemast, the Italian Society of Dermatology and Sexually Transmitted Diseases: “Adequate photoprotection must include the reduction of intentional photoexposure by modifying lifestyle habits in relation to going to the seaside and looking for a tan”
In light-skinned populations, “it is estimated that up to 95% of malignant keratinocyte tumors, such as basal cell and squamous cell carcinoma, and 70-95% of melanomas are caused by UV radiation – recalls the scientific society of dermatologists – Therefore, a significant percentage of skin cancers can be prevented by reducing unnecessary and excessive UV radiation through effective photoprotection.” But resisting the ‘tan’ is difficult and for those who work outdoors it is inevitable to avoid the sun’s rays. And so the watchword is: “protect yourself with adequate photoprotection. Therefore, use clothing, a wide-brimmed hat and sunglasses, apply sunscreen with a ’30-50 +’ factor and a UVA label on all the skin areas that cannot be protected by clothing – Sidemast underlines – Last but not least, give up the use of sunbeds.
These are the practical and concise recommendations based on scientific evidence for the prevention of skin cancer and correct photoprotection coming from international experts from 5 continents – Africa, America, Asia, Australia and Europe – and from the European Association of Dermato Oncology scientific societies, Euromelanoma, Euroskin, European Union of Medical Specialists and Melanoma World Society, recently published in the ‘European Journal of Cancer’.
The increase in the incidence of melanoma can be highlighted by analyzing the long-term trend
The ‘international consensus’ of experts saw as co-authors professors Maria Concetta Fargnoli, vice president of Sidemast and full professor of Dermatology at the University of L’Aquila and Ketty Peris, past president of Sidemast and full professor of Dermatology at the University Catholic of Rome. Among the Italians also Professor Caterina Longo of the University of Modena and Reggio Emilia, Professor Giovanni Pellicani of the Sapienza University of Rome and Iris Zalaudek of the University of Trieste.
And the theme of prevention will be at the center of the 98th National Sidemast congress which will be held in Giardini di Naxos (Me) from 28 to 31 May, chaired by professors Giuseppe Micali (Catania) and Luca Stingeni (Perugia). “The majority of the European population goes on holiday in the sun, often several times a year – highlights Maria Concetta Fargnoli – this behavior is deeply rooted, it will be difficult to change and this change may take decades. We must therefore start with clear and unequivocal messages, certainly radical, but which should be included in the educational activity for the patient. Furthermore, a lot of time would be saved if at least dermatologists spoke the same language.”
The increase in the incidence of melanoma can be highlighted by analyzing the long-term trend. “For example, in 1950 the Danish Cancer Registry documented one case of melanoma per 100,000 inhabitants, rising to three cases per 100,000 in 1970, then ten cases in 1990, 25 cases in 1990 and 50-70 cases predicted for 2036 The 50-fold increase in less than 90 years is unique among all tumors and the trend in the incidence of keratinocyte tumors is very similar”, recalls Sidemast.
‘Peris, ‘adequate photoprotection is the combination of: shade, use of clothing, hats and glasses and the application of sunscreens’
Fair-skinned individuals, particularly children, should therefore minimize their exposure to UV radiation by taking sun protection measures when the UV index, which quantifies the intensity of solar UV radiation at the Earth’s surface, is expected to reaches a value of 3 or higher. “Adequate photoprotection – explains Professor Ketty Peris – derives from the combination of several measures such as seeking shade, the use of clothing, hats and glasses and the application of sun screens on exposed areas. However, in clinical practice, people tend to overestimate the protection provided by sunscreens, resulting in a false feeling of reassurance when they go to the beach and expose themselves to the sun. This could encourage risk behavior for the onset of skin cancer.”
The protective properties of clothes, hats and sunglasses are therefore strategic. Epidemiological studies have repeatedly found a reduction in the risk of sunburn, the development of moles in children and melanoma thanks to the sun protection offered by clothing compared to sunscreens. “The protective properties of clothing – explain dermatologists – vary based on the type of fiber (polyester, nylon > wool, silk > cotton), the density of the weave, the color (the dyes help block UV rays), the design (e.g., long sleeves, collar) and the incorporation of molecules that absorb UV rays. Clothing with a high UV protection factor is also particularly useful in conditions of high UV exposure, such as outdoor sports and water sports. Hats should have wide brims to protect the scalp, face, neck and ears.”
‘The reduction of intentional photoexposure involves changing lifestyle habits’
“Adequate photoprotection – adds Sidemast – should therefore include the reduction of intentional photoexposure by modifying lifestyle habits in relation to going to the seaside and looking for a tan: “This would allow us to continue carrying out our professional or leisure by exposing ourselves to the sun safely and without harm”.
Protection from UV rays also has a positive return in terms of investment “because it allows us to reduce the incidence of the disease and therefore its economic burden. According to WHO data, one tumor in 3 is a skin tumor. The reduction of exposure to UV rays therefore represents a crucial strategy to control the recent epidemic of skin cancers”, continue the dermatologists.
“Politicians should communicate strong messages about UV protection to the public and discourage the use of commercial artificial UV radiation sources, through strict regulation or preferably a ban. They should ensure communication and education of the population on the daily UV index, for example with weather reports, and create structures with outdoor shade in schools and recreational areas”, finally suggests Fargnoli, Sidemast vice president.
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