Ideally, the main outcome measure of studies addressing sunscreen use and cancer risk would be numbers of incident cancers in those using sunscreens compared with those not using sunscreens. However, this is unrealistic because of the long latency period for a skin cancer to develop and the relative rarity of such events. Surrogate outcome measures such as reported protective behaviour are therefore often used in studies. Intermediate outcomes such as incidence of actinic keratoses or reduction in naevi are also used as short-term surrogates for longer term skin cancer risk. All of these surrogate measures have their problems. There are many confounding factors when assessing sunscreen use. Many studies use behaviour (for example, reported use of suncreen or sun avoidance) as the outcome measure. The data may still be unreliable as recall of use is not necessarily accurate and other protective measures are confounding factors. Lack of specificity of outcome measures remains problematic.
Can the use of sunscreen prevent cutaneous melanoma?
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