USPSTF: Behavioral Counseling of Children and Teens to Prevent Skin Cancer Recommended Interview with:

John W. Epling, Jr., M.D.

Dr. Epling

John W. Epling, Jr., M.D., M.S.Ed., Task Force Member
Dr. Epling is is a professor of Family and Community Medicine at the Virginia Tech Carilion School of Medicine in Roanoke, VA. He is also the Medical Director of Research for Family and Community Medicine, Medical Director of Employee Health and Wellness for the Carilion Clinic, and maintains an active clinical primary care practice. What is the background for this study? What are the main findings?

Response: Skin cancer is the most common type of cancer in the U.S., affecting millions of people every year. The Task Force looked at the latest research to see if clinicians can help people prevent skin cancer by providing counseling about ways to reduce risk, including using sunscreen, wearing protective clothing, and avoiding sunlight during peak hours.

Sunburn damaged skin - wiki image

Sunburn damage – wiki image

Based on our review of the evidence, we found that counseling younger patients with a fair skin type and their parents is effective at encouraging these sun protective behaviors. By helping reduce their patients’ exposure to harmful UV rays, clinicians can decrease their risk for skin cancer. As such, we recommend that clinicians provide counseling to people who are six months to 24 years old and have a fair skin type. For adults over 24 with a fair skin type, clinicians should consider the individual’s risks for skin cancer when deciding whether or not to provide counseling. What should readers take away from your report?

 Response: We found that the overall benefit of counseling to teach people how to protect themselves from the sun was greatest in children and teens. This is because significant exposure to UV rays during childhood and adolescence, especially sunburns, increases the risk of skin cancer later in life. Clinicians can help alleviate this risk by providing a variety of counseling interventions, such as online programs and child-friendly print materials, to patients who are six months to 24 years old and have a fair skin type, as well as their parents. What recommendations do you have for future research as a result of this work? 

Response: The Task Force is calling for additional research in multiple areas. These include studies that look at the effectiveness of teaching sun protective behaviors to adults and young adults, whether people continue skin cancer prevention behaviors after trials are concluded, and the benefits and harms of teaching skin self-examinations. More studies with long-term follow-up periods that include racially and ethnically diverse populations are also needed. Is there anything else you would like to add?

Response: By providing counseling about ways that people can reduce their exposure to the sun, clinicians can help people reduce their risk for skin cancer. This is especially effective when counseling is provided at a young age. There are many types of counseling programs that have been proven to work, so clinicians should talk to their patients about their individual preferences and risks. Anyone who is concerned about their risk for skin cancer should discuss the best ways to protect themselves with their clinician.


Behavioral Counseling to Prevent Skin CancerUS Preventive Services Task Force Recommendation Statement. JAMA. 2018;319(11):1134–1142. doi:10.1001/jama.2018.1623

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