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Feature Article

The dangers of sun exposure: practical approaches to skin cancer prevention

Diona Damian

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Abstract

In Australia, skin cancer is more common than all other cancers combined. Practical skin cancer prevention strategies are important and effective for older Australians as well as for young people, and are critically important for individuals chronically immune suppressed by their medications or by lymphoid malignancy.

Key Points

  • Skin cancer is four times as common in Australia as all other cancers combined.
  • Ultraviolet (UV) radiation-induced DNA damage and suppression of the skin’s antitumour immune defences are key pathways in skin carcinogenesis. Even very low doses of UV radiation can damage DNA and profoundly suppress skin immunity.
  • Regular sunscreen use can substantially reduce the incidence of premalignant actinic keratoses, cutaneous squamous cell carcinoma, and possibly basal cell carcinoma and melanoma.
  • Skin cancer prevention is effective and important in later life as well as in young people.
  • Skin cancer prevention is especially important in immune-suppressed transplant recipients and those immune suppressed by chronic lymphoid malignancy.
  • High-risk patients may require systemic chemoprevention, usually with retinoids, such as acitretin, in addition to sun-protective behaviour, clothing, sunglasses and sunscreens.
  • Oral nicotinamide (vitamin B3) protects from UV immunosuppression and is now being evaluated for its ability to reduce skin cancer incidence.

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