Expert Consensus on Sunscreen for the Primary Prevention of Skin Cancer: Results of the Skin Cancer Prevention Working Group Conference

Background: Melanoma and non-melanoma skin cancers (NMSC) are the overall most common type of malignancy. Despite this fact, the use of sunscreen as a primary preventative measure for skin cancer is not ubiquitous. Objective: To review the literature regarding efficacy and safety of sunscreens and to process and condense data into overarching principles to provide guidance to the general public and improve outcomes for melanoma NMSC. Methods: A systematic review of the literature pertaining to sunscreen efficacy in the primary prevention of melanoma and non-melanoma skin cancer, safety in humans and environmental impact was conducted. Following a thorough review of the literature, the Skin Cancer Prevention Working Group (SCPWG), an expert panel consisting of dermatologists with specialized training in melanoma and NMSC diagnosis and management, employed a modified Delphi technique to reach consensus over the development of statements regarding the current level of evidence for sunscreen efficacy and safety. Final statements were only adopted after achieving a supermajority vote >80%. Results: 96 articles were identified for further review and discussion. The SCPWG developed 7 consensus statements regarding the efficacy and safety of sunscreens and their role in the prevention of melanoma and NMSC. Conclusion: The proven benefits of primary skin cancer prevention outweigh the potential/hypothetical risks of sunscreen use, especially given insufficient real-world, prospective data for the discussed risks. As experts in skin health and skin cancer pathophysiology, the SCPWG believes dermatologists are uniquely qualified to lead future studies investigating sunscreen efficacy and safety and should counsel patients and the public on skin cancer primary prevention strategies.