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This Week in JAMA: Jun 29, 2011

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Online first in JAMA this week, Northwestern University Feinberg School of Medicine's June Robinson and Beth Israel Deaconess Medical Center's Michael Bigby present a commentary on the use of sunscreen to prevent melanoma. Evidence from several trials shows that regular use of sunscreen can prevent cutaneous squamous cell carcinoma. One such study, conducted in Australia, included 1.621 adults randomized to regular sunscreen use or discretionary use, including no use at all, the Robinson and Bigby write. In the 10 years after cessation of the trial, 11 new primary melanomas were identified among the 812 people in the sunscreen group compared with 22 melanomas in the discretionary use group. "Since exposure to UV radiation is the only known modifiable cause of melanoma, this study is a potential 'game changer' for the primary prevention of melanoma," Robinson and Bigby say. "Patients at high risk for skin cancer because of phenotypic characteristics (fair skin, freckling, and tendency to sunburn) who live in or visit sunny climates or who have a family history of melanoma should routinely and thoroughly apply sunscreen before going outside." They add that sun protection counseling is relevant for people at risk for developing melanomas.

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