Queensland Institute of Medical Research, PO Royal Brisbane Hospital, Queensland 4029, Australia.
J Clin Oncol. 2011 Jan 20;29(3):257-63. doi: 10.1200/JCO.2010.28.7078. Epub 2010 Dec 6.
Regular sunscreen use prevents cutaneous squamous cell carcinoma long term, but the effect on melanoma is highly controversial. We evaluated whether long-term application of sunscreen decreases risk of cutaneous melanoma.
In 1992, 1,621 randomly selected residents of Nambour, a township in Queensland, Australia, age 25 to 75 years, were randomly assigned to daily or discretionary sunscreen application to head and arms in combination with 30 mg beta carotene or placebo supplements until 1996. Participants were observed until 2006 with questionnaires and/or through pathology laboratories and the cancer registry to ascertain primary melanoma occurrence.
Ten years after trial cessation, 11 new primary melanomas had been identified in the daily sunscreen group, and 22 had been identified in the discretionary group, which represented a reduction of the observed rate in those randomly assigned to daily sunscreen use (hazard ratio [HR], 0.50; 95% CI, 0.24 to 1.02; P = .051). The reduction in invasive melanomas was substantial (n = 3 in active v 11 in control group; HR, 0.27; 95% CI, 0.08 to 0.97) compared with that for preinvasive melanomas (HR, 0.73; 95% CI, 0.29 to 1.81).
Melanoma may be preventable by regular sunscreen use in adults.
定期使用防晒霜可长期预防皮肤鳞状细胞癌，但防晒霜对黑色素瘤的影响存在很大争议。我们评估了长期使用防晒霜是否会降低皮肤黑色素瘤的风险。
1992 年，澳大利亚昆士兰州楠伯尔镇随机抽取了 1621 名年龄在 25 至 75 岁之间的居民，他们被随机分配每天或随意使用防晒霜涂抹头部和手臂，并结合服用 30 毫克β胡萝卜素或安慰剂补充剂，直到 1996 年。参与者在 2006 年之前通过问卷调查和/或通过病理实验室和癌症登记处来确定原发性黑色素瘤的发生情况。
试验停止 10 年后，每天使用防晒霜组发现 11 例新的原发性黑色素瘤，随意使用防晒霜组发现 22 例，这表明随机分配到每天使用防晒霜组的观察发病率降低（风险比[HR]，0.50；95%置信区间，0.24 至 1.02；P =.051）。侵袭性黑色素瘤的减少幅度很大（活跃组 n = 3，对照组 n = 11；HR，0.27；95%置信区间，0.08 至 0.97），与非侵袭性黑色素瘤（HR，0.73；95%置信区间，0.29 至 1.81）相比。
成年人定期使用防晒霜可能可预防黑色素瘤。
