Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN 55454, USA.
Cancer Epidemiol Biomarkers Prev. 2011 Dec;20(12):2583-93. doi: 10.1158/1055-9965.EPI-11-0705. Epub 2011 Oct 20.
Epidemiologic evidence supporting sunscreen for melanoma prevention is limited to one small trial; case-control studies report conflicting results. Sunscreen usage patterns or alternative sun protection methods have rarely been studied in relation to melanoma.
In a population-based case-control study, participants (1,167 cases; 1,101 controls) reported for each decade year of age outdoor activity-related sunscreen use, sunscreen patterns (SPF15+, amount, skin coverage, reapplication, routine use), and use of other sun protection methods (like hats, long-sleeved shirts, staying in the shade). Scores were averaged across activities and/or decades; scores in the most recent two decades were used to classify individuals as non-, inconsistent- or optimal users. Adjusted mean score differences between cases and controls, and ORs and 95% CIs for melanoma among optimal-, inconsistent- versus nonusers were calculated.
Mean scores for sunscreen, sunscreen patterns or other sun protection methods were low, but higher among controls than cases for SPF15+ sunscreen (P = 0.03) and other sun protection methods (P = 0.006). Adjusted ORs for optimal use of sunscreen and most sunscreen patterns were null or relatively weak, except for routine sunscreen (adjusted OR = 0.44, 95% CI: 0.23-0.86). Optimal use of other sun protection methods was inversely associated with melanoma (adjusted OR = 0.59, 95% CI: 0.44-0.78).
Optimal use of routine sunscreen or other sun protection methods were most strongly associated with decreased melanoma risk; results are limited by the small number of subjects who used sunscreen routinely and lack of specificity regarding other sun protection methods.
Both improving sunscreen practices and encouraging sun avoidance strategies may be important for melanoma prevention.
支持防晒霜预防黑色素瘤的流行病学证据仅限于一项小型试验；病例对照研究报告结果相互矛盾。防晒霜使用模式或替代防晒方法很少与黑色素瘤相关进行研究。
在一项基于人群的病例对照研究中，参与者（1167 例病例；1101 例对照）报告了每十年户外活动相关防晒霜使用、防晒霜模式（SPF15+、用量、皮肤覆盖、重复使用、常规使用）和其他防晒方法（如帽子、长袖衬衫、待在阴凉处）的使用情况。分数在活动和/或十年之间平均计算；最近二十年的分数用于将个体分类为非、不一致或最佳使用者。计算病例和对照之间防晒霜、防晒霜模式或其他防晒方法的平均得分差异，以及最佳、不一致与非使用者之间黑色素瘤的 OR 和 95%CI。
防晒霜、防晒霜模式或其他防晒方法的平均得分较低，但对照者的得分高于病例，SPF15+防晒霜（P = 0.03）和其他防晒方法（P = 0.006）。最佳使用防晒霜和大多数防晒霜模式的调整后 OR 为零或相对较弱，除了常规防晒霜（调整后 OR = 0.44，95%CI：0.23-0.86）。最佳使用其他防晒方法与黑色素瘤呈负相关（调整后 OR = 0.59，95%CI：0.44-0.78）。
常规防晒霜或其他防晒方法的最佳使用与黑色素瘤风险降低最密切相关；由于定期使用防晒霜的受试者数量较少且其他防晒方法缺乏特异性，结果受到限制。
改善防晒霜使用习惯和鼓励避免阳光策略可能对预防黑色素瘤都很重要。
