The importance of sun safety: Sun Awareness Week 2024

Sun Awareness Week (6-12 May) kicks off the British Association of Dermatologists’ (BAD) summer-long campaign dedicated to raising awareness of non-melanoma skin cancer, a very common type of cancer. The week also aims to teach the public about the importance of good sun protection habits, including ways you can check for signs of skin cancer.  

What is non-melanoma skin cancer, and how does it differ from melanoma?

Non-melanoma skin cancer is a group of cancers that develop in the outer layer of the skin, unlike melanoma which starts in the cells that produce pigment in the skin.

The two most common types of non-melanoma skin cancer are basal cell and squamous cell carcinomas, which are keratinocyte cancers. They can be prevented and treated with sun avoidance behaviours, but their prevalence is on the rise.

John Ingram, Editor-in-Chief of the British Journal of Dermatology, believes that Sun Awareness Week is a good time to spotlight recent research outputs in the fields of melanoma and non-melanoma skin cancer. A new collection from the BAD journals presents key research studies on the topic, ranging from the use of artificial intelligence large language models in management advice, to skin risk evaluation for people of colour with a history of non-melanoma skin cancer.

Let’s look at some of the key findings from the collection:

Actinic keratosis is a global health concern

Actinic keratosis is a form of dry, scaly patches of skin caused by sun damage. In a recent systematic review, it was found that actinic keratosis has a global prevalence rate of 14%, with prevalence increasing the closer you get to the equator. Wearing sunscreen and sun-protective clothing has been shown to help reduce its prevalence.

Genetic factors may put you at higher risk of nodular melanoma

Nodular melanoma is an invasive type of melanoma that appears as an enlarging lump that is often diagnosed at later stages than non-nodular forms of melanoma. A study found that an increased number of rare gene variants could help identify patients at higher risk of this form of melanoma.

People of colour at risk of developing melanoma following keratinocyte carcinomas

Patients with a history of keratinocyte carcinomas are at an increased risk of developing melanoma but there is a lack of research on patients with skin of colour. A recent retrospective study investigated the risk of melanoma in skin of colour patients with a history of keratinocyte carcinoma and found that it was associated with an 85% increased risk of melanoma.

Non-melanoma skin cancer is predicted to have a higher mortality rate than malignant melanoma

In another recent study, it was predicted that non-melanoma skin cancer mortality will soon be higher than malignant melanoma, reaching this threshold first in Scotland (2028), followed by the United States (2031), Australia (2033), and England (2038), but later for Nordic countries (beyond 2050).  

Autoimmune hepatitis is linked to melanoma and non-melanoma skin cancer

Autoimmune hepatitis is a disorder characterized by its remitting course, often requiring long-term immunosuppressive therapy. A study showed that patients with autoimmune hepatitis had increased odds of developing basal cell carcinoma, cutaneous squamous cell carcinoma and melanoma. Due to their increased risk of skin cancer, patients may benefit from regular dermatological care and skin examinations.   

IBD drug is linked to a higher risk of cutaneous squamous cell carcinoma

Azathioprine is a drug used to treat inflammatory bowel disease (IBD). A recent study found a 56% increase in the risk of cutaneous squamous cell carcinoma in patients taking azathioprine compared with those taking other immunosuppressive drugs. As newer immunosuppressive agents become available, clinicians should carefully consider the individual’s skin cancer risk before prescribing. 

Self-perception impacts sun-related behaviours

A survey of over 5,000 people found that those who perceived their health as positive were associated with higher odds of tanning and sunburn history. These individuals may be more likely to spend time outdoors and be more willing to practise risky behaviours.

Low sunscreen use recorded in students 

Sunscreen use in the United States was shown to be relatively low in a student study, with men of colour and older adolescents at the greatest risk for not using sunscreen at all. Reasons for avoiding sunscreen use were multifactorial, including lower levels of skin cancer knowledge, viewing sunscreen as a beauty product, and social-cultural norms. Skin cancer prevention will need to target these specific populations to generate the most significant impact on changing sunscreen habits.

Can artificial intelligence (AI) provide clinical advice about melanoma?

This study showed that ChatGPT marginally outperforms BARD and BingAI in providing reliable, evidence-based clinical advice for melanoma. However, these technologies still face limitations in depth and specificity and further research is needed to improve their performance.

Sun Awareness Week highlights the need for sun protection, education, and awareness about lesser-known skin cancers, as well as the increasing burden of non-melanoma skin cancer. If there are any changes to skin lesions or moles, then it is best to consult your doctor.

Contribute to the conversation this #SunAwarenessWeek and explore the latest research collection from the BAD journals.

_{Featured image by NicholayFrolochkin via Pixabay.}