Counselling of young adults, adolescents, children, and parents of young children about minimising exposure to UV radiation for people aged 6 months to 24 years with fair skin types to reduce their risk of skin cancer is recommended by the US Preventive Services Task Force.[67]US Preventive Services Task Force, Grossman DC, Curry SJ, et al. Behavioral counseling to prevent skin cancer: US Preventive Services Task Force recommendation statement. JAMA. 2018 Mar 20;319(11):1134-42.
https://jamanetwork.com/journals/jama/fullarticle/2675556
http://www.ncbi.nlm.nih.gov/pubmed/29558558?tool=bestpractice.com
Counselling should be selectively offered to adults older than 24 years with fair skin types about minimising their exposure to UV radiation to reduce risk of skin cancer.[67]US Preventive Services Task Force, Grossman DC, Curry SJ, et al. Behavioral counseling to prevent skin cancer: US Preventive Services Task Force recommendation statement. JAMA. 2018 Mar 20;319(11):1134-42.
https://jamanetwork.com/journals/jama/fullarticle/2675556
http://www.ncbi.nlm.nih.gov/pubmed/29558558?tool=bestpractice.com
Sun protection to prevent UV irradiation should be encouraged including the use of sunscreens with UV-A and UV-B spectrum coverage, sunblocks (e.g., titanium dioxide, zinc dioxide), physical sun protection with clothing and hats, and sun avoidance.[68]Farmer KC, Naylor MF. Sun exposure, sunscreens, and skin cancer prevention: a year-round concern. Ann Pharmacother. 1996 Jun;30(6):662-73.
http://www.ncbi.nlm.nih.gov/pubmed/8792954?tool=bestpractice.com
[69]Gordon LG, Scuffham PA, van der Pols JC, et al. Regular sunscreen use is a cost-effective approach to skin cancer prevention in subtropical settings. J Invest Dermatol. 2009 Dec;129(12):2766-71.
https://www.jidonline.org/article/S0022-202X(15)34166-X/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/19536149?tool=bestpractice.com
[70]Hirst NG, Gordon LG, Scuffham PA, et al. Lifetime cost-effectiveness of skin cancer prevention through promotion of daily sunscreen use. Value Health. 2012 Mar-Apr;15(2):261-8.
http://www.ncbi.nlm.nih.gov/pubmed/22433757?tool=bestpractice.com
[71]Rönsch H, Bauer A. The preventive value of sun protection. Curr Probl Dermatol. 2021;55:316-28.
http://www.ncbi.nlm.nih.gov/pubmed/34698024?tool=bestpractice.com
The use of indoor tanning units (sunbeds) should be discouraged.
Randomised controlled trials have shown a reduction in squamous cell carcinoma (SCC) incidence in people who regularly apply sunscreen.[67]US Preventive Services Task Force, Grossman DC, Curry SJ, et al. Behavioral counseling to prevent skin cancer: US Preventive Services Task Force recommendation statement. JAMA. 2018 Mar 20;319(11):1134-42.
https://jamanetwork.com/journals/jama/fullarticle/2675556
http://www.ncbi.nlm.nih.gov/pubmed/29558558?tool=bestpractice.com
[72]Green A, Williams G, Neale R, et al. Daily sunscreen application and betacarotene supplementation in prevention of basal-cell and squamous-cell carcinoma of the skin: a randomised controlled trial. Lancet. 1999 Aug 28;354(9180):723-9.
http://www.ncbi.nlm.nih.gov/pubmed/10475183?tool=bestpractice.com
[73]Thompson SC, Jolley D, Marks R. Reduction of solar keratoses by regular sunscreen use. N Engl J Med. 1993 Oct 14;329(16):1147-51.
https://www.nejm.org/doi/full/10.1056/NEJM199310143291602
http://www.ncbi.nlm.nih.gov/pubmed/8377777?tool=bestpractice.com
[74]Darlington S, Williams G, Neale R, et al. A randomized controlled trial to assess sunscreen application and beta carotene supplementation in the prevention of solar keratoses. Arch Dermatol. 2003 Apr;139(4):451-5.
https://jamanetwork.com/journals/jamadermatology/fullarticle/479276
http://www.ncbi.nlm.nih.gov/pubmed/12707092?tool=bestpractice.com
While there is no good evidence to support periodic screening in people prior to the development of SCC, or in those who are not at high risk, most experienced clinicians recommend that a yearly total body skin examination should be performed in all at-risk patients, preferably by a dermatologist, particularly in those >50 years of age.
Actinic keratoses should be treated at first development.[75]National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: squamous cell skin cancer [internet publication].
https://www.nccn.org/guidelines/category_1
See Actinic keratosis
Solid organ transplant recipients
Solid organ transplant recipients (especially those with white skin and a history of significant sun exposure) have a high risk of developing SCC. To prevent the onset of disease in patients with no actinic keratosis and photodamage only, preventive measures should be encouraged, including patient education, sun protection strategies, sunscreen, and/or skin surveillance.[12]Massey PR, Schmults CD, Li SJ, et al. Consensus-based recommendations on the prevention of squamous cell carcinoma in solid organ transplant recipients: a Delphi consensus statement. JAMA Dermatol. 2021 Sep 1 [Epub ahead of print].
http://www.ncbi.nlm.nih.gov/pubmed/34468690?tool=bestpractice.com