Less Than 1% of U.S. Physicians Mention Sunscreen to Patients

Despite the steady rise in the incidence of melanoma over the past three decades, a recent study found that less than 1% of U.S. physicians mention sunscreen to patients—even those with a history of skin cancer.

Researchers used data from the National Ambulatory Medical Care Survey about outpatient physician office visits from January 1989 through December 2010. They isolated visits during which it was recorded that sunscreen was currently being used by the patient, was dispensed in the doctor’s office, or was recommended by the physician.

Out of the 18.3 billion patient visits they studied, sunscreen was mentioned by the physician in just 0.07%. When looking specifically at visits with general practice/family doctors, that percentage dropped to just 0.03%.

“Our study suggests that rates of sunscreen recommendation have risen over time, so they would probably be somewhat higher for more recent years,” said study co-author Scott Davis, MA, assistant director of the Center for Dermatology Research at Wake Forest University, in Winston-Salem, N.C. “Nonetheless, the rates of sunscreen recommendation are very, very low, and while the increased media awareness is excellent, there is no evidence that it is linked to changes in clinician behavior.”

Data showed that sunscreen was mentioned most frequently to white patients, particularly those in their 70s, and least frequently to children. The authors expressed concern about the low level of sunscreen recommendation among the pediatric population, as they are likely to have the greatest amount of sun exposure of all age groups.

They also evaluated patient visits associated with a diagnosis of skin disease. Sunscreen was mentioned at 0.9% of these visits—a rate slightly higher than that seen in general visits but still alarmingly low. When it came to visits associated with a diagnosis of an active or previous history of skin cancer, family physicians seemed to talk about sunscreen more frequently than dermatologists. General practice/family doctors mentioned sunscreen at 55.5% of visits among this patient population, while the skin specialists only mentioned it at 11.2%.

The authors noted that one potential limitation of the study is that physicians may have failed to document sunscreen recommendations at all visits. But Davis said, “even if sun protection recommendations were recorded only 1 in 10 times they were given, recommendations are still given far too seldom.”

 “Counseling on smoking and nutrition is already a standard part of primary care visits, but sun protection is not,” he said. “The most important take-home message for PCPs is they can help reduce the ongoing epidemic of skin cancers (by talking more with patients about sun protection).”

The complete study is published in the September issue of JAMA Dermatology.

—Colleen Mullarkey

Reference

Akamine KL, Gustafson CJ, Davis SA, Levender MM, Feldman SR. Trends in sunscreen recommendation among US physicians. JAMA Dermatol. 2013 Sept 4; doi:10.1001/jamadermatol.2013.4741