The Skin Cancer Paradox
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Jan 30, 2024
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Abstract
Although the safety and efficacy of ultraviolet filters (sunscreens) is widely accepted by consumers and medical professionals, the scientific community has yet to validate this conclusion. This is evident based on multiple literature searches obtained from PubMed, Google Scholar, ScienceDirect, ResearchGate, sunscreen manufacturers and dermatologic organization websites. In the absences of definitive data, industry continues to promote the use of these products to prevent cancers, specifically a 40% reduction in squamous cell carcinoma and a 50% reduction in melanoma based on one confounded non-reproduced study with numerous design flaws. This causes consumers to be misinformed leading them to intentionally increase ultraviolet light exposure, increasing their risk of skin cancers. Until the scientific community can clearly demonstrate that these products reduce/eliminate skin cancers, consumers should follow sun avoidance measures.
Article Details
How to Cite
DINARDO, Joseph C..
The Skin Cancer Paradox.
Medical Research Archives, [S.l.], v. 12, n. 1, jan. 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4964>. Date accessed: 15 may 2024.
doi: https://doi.org/10.18103/mra.v12i1.4964.
Section
Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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13. Garbe B, Kockott D, Werner M, et al. The Influence of Short-Wave and Long-Wave Radiation Spectrum on the Photostability of Sunscreens. Skin Pharmacol Physiol. 2020;33(2):77-85.
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24. Gonzalez H, Tarras-Wahlberg N, Stromdahl B, et al. Photostability of commercial sunscreens upon sun exposure and irradiation by ultraviolet lamps. BMC Dermatol. 2007 Feb 26;7:1.
25. Sayre RM, Dowdy J, Gerwig AJ, et al. Unexpected Photolysis of the Sunscreen Octinoxate in the Presence of the Sunscreen Avobenzone. Photochem Photobiol. 2005 Mar-Apr;81(2):452-6.
26. Chatelain E, and Gabard B. Photostabilization of butyl methoxydibenzoylmethane (Avobenzone) and ethylhexyl methoxycinnamate by bis-ethylhexyloxyphenol methoxyphenyl triazine (Tinosorb S), a new UV broadband filter. Photochem Photobiol. 2001 Sep;74(3):401-6.
27. Scribd – Nguyen and Schlossman: Stability Study of Avobenzone With Inorganic Sunscreens. Kobo Products, Inc. Available at https://www.scribd.com/document/499910109/10-1-1-738-6177# Last viewed November 16, 2023.
28. Bredholt K, Christensen T, Hannevik M, et al. [Effects of sunscreening agents and reactions with ultraviolet radiation] Tidsskr Nor Laegeforen. 1998 Jun 30;118(17):2640-5.
29. DiNardo JC, Downs CA. Fall from GRASE: The Sunsetting of the Sunscreen Innovation Act. American Journal of Dermatological Research and Reviews. 2021, 4:39. Available at https://escipub.com/Articles/AJODRR/AJODRR-2020-12-2805.pdf - Last viewed November 16, 2023.
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34. Siegel RL, Miller KD, Fuchs HE and Jemal, A. Cancer Statistics, 2022. CA Cancer J Clin. 2022;72(1):7-33.
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36. Stasko T and Hanlon AM. Epidemiology and risk factors for skin cancer in solid organ transplant recipients. UpToDate: Available at https://www.uptodate.com/contents/epidemiology-and-risk-factors-for-skin-cancer-in-solid-organ-transplant-recipients#:~:text=Predictors%20of%20post%2Dtransplant%20skin,%25%20CI%202.12%2D3.21. Last viewed November 16, 2023.
37. Guy Jr GP, Machlin SR, Ekwueme DU, and Yabroff KR. Prevalence and Costs of Skin Cancer Treatment in the U.S., 2002–2006 and 2007–2011. Am J Prev Med. 2015;48(2):183-187.
2. Green AC, Williams GM, Logan V, et al.. Reduced melanoma after regular sunscreen use: randomized trial follow-up. J Clin Oncol. 2011 Jan 20;29(3):257-63.
3. Vainio H, Miller AB, Bianchini F. Publication of the International Union Against Cancer: An international evaluation of the cancer-preventive potential of sunscreens. Meeting held at Lyon, France, 10–18, 2000. Int. J. Cancer: 88, 838–842.
4. Emmett EA. Ultraviolet radiation as a cause of skin tumors. CRC Crit Rev Toxicol. 1973;2(2):211-55.
5. Wolf P, Donawho CK, Kripke ML. Effect of sunscreens on UV radiation-induced enhancement of melanoma growth in mice. J Natl Cancer Inst. 1994;86(2):99-105.
6. Environmental Protection Agency (EPA) - Sunscreen the burning facts 2006. Is sunscreen fail-safe (pg6). Available at https://www.epa.gov/sites/default/files/documents/sunscreen.pdf - Last viewed November 16, 2023.
7. Planta MB. Sunscreen and melanoma: is our prevention message correct? J Am Board Fam Med. 2011;24(6):735-9.
8. Saes da Silva E, Tavares R, da Saliva Paulitsch F, et al. Use of sunscreen and risk of melanoma and non-melanoma skin cancer: a systematic review and meta-analysis. Eur J Dermatol. 2018;28:186–201.
9. Waldman RA, Grant-Kels JM. The role of sunscreen in the prevention of cutaneous melanoma and nonmelanoma skin cancer. J Am Acad Dermatol. 2019;80(2):574-576.e1.
10. Godar DE. UV and Reactive Oxygen Species Activate Human Papillomaviruses Causing Skin Cancers. Curr Probl Dermatol. 2021;55:339-353.
11. Serpone N. Sunscreens and their usefulness: have we made any progress in the last two decades. Photochem Photobiol Sci 2021; 20(2): 189–244.
12. Gholap AD, Sayyad S, Hatvate NT, et al: Drug Delivery Strategies for Avobenzone: A Case Study of Photostabilization: Pharmaceutics 2023; 15,1008.
13. Garbe B, Kockott D, Werner M, et al. The Influence of Short-Wave and Long-Wave Radiation Spectrum on the Photostability of Sunscreens. Skin Pharmacol Physiol. 2020;33(2):77-85.
14. Lebedev AT, Kralj MB, Polyakova OV, et al. Identification of avobenzone by-products formed by various disinfectants in different types of swimming pool waters. Environ Int. 2020 Apr;137:105495.
15. Herzog B, Giesinger J, Settels V. Insights into the stabilization of photolabile UV-absorbers in sunscreens. Photochem Photobiol Sci. 2020 Dec 1;19(12):1636-1649.
16. Yuan L, Li S, Huo D, et al. Studies on the preparation and photostability of avobenzone and (2-hydroxy)propyl-β-cyclodextrin inclusion complex. J Photochem Photobio A: Chem. 2019 Jan 15;(369):174-180.
17. Berardesca E, Zuberbier T, Sanchez Viera M, et al. Review of the safety of octocrylene used as an ultraviolet filter in cosmetics J Eur Acad Dermatol Venereol. 2019 Nov;33 Suppl 7:25-33.
18. People4Ocean Sun Care Sept 16, 2018. Sun of a Screen. https://www.people4ocean.com/blogs/blog/sun-of-a-screen - Last viewed November 16, 2023.
19. ProspectorR - Avobenzone: A Globally Approved UVA Absorber Posted on March 27, 2015. https://www.ulprospector.com/knowledge/2232/pcc-avobenzone-globally-approved-uva-absorber/ - Last viewed November 16, 2023.
20. Stylecaster - Octinoxate and Avobenzone. https://stylecaster.com/beauty/skin-care/425336/skin-care-ingredients-you-should-never-combine/ Last viewed November 16, 2023.
21. Hojerová J, Medovcikova A, Mikula M. Photoprotective efficacy and photostability of fifteen sunscreen products having the same label SPF subjected to natural sunlight. Int J Pharm. 2011 Apr 15;408(1-2):27-38.
22. Beasley DG, and Meyer TA. Characterization of the UVA Protection Provided by Avobenzone, Zinc Oxide, and Titanium Dioxide in Broad-Spectrum Sunscreen Products. Am J Clin Dermatol. 2010 Dec 1;11(6):413-21.
23. Paris C, Lhiaubet-Vallet V, Jimenez O, et al. A blocked diketo form of avobenzone: photostability, photosensitizing properties and triplet quenching by a triazine-derived UVB-filter. Photochem Photobiol. 2009 Jan-Feb;85(1):178-84
24. Gonzalez H, Tarras-Wahlberg N, Stromdahl B, et al. Photostability of commercial sunscreens upon sun exposure and irradiation by ultraviolet lamps. BMC Dermatol. 2007 Feb 26;7:1.
25. Sayre RM, Dowdy J, Gerwig AJ, et al. Unexpected Photolysis of the Sunscreen Octinoxate in the Presence of the Sunscreen Avobenzone. Photochem Photobiol. 2005 Mar-Apr;81(2):452-6.
26. Chatelain E, and Gabard B. Photostabilization of butyl methoxydibenzoylmethane (Avobenzone) and ethylhexyl methoxycinnamate by bis-ethylhexyloxyphenol methoxyphenyl triazine (Tinosorb S), a new UV broadband filter. Photochem Photobiol. 2001 Sep;74(3):401-6.
27. Scribd – Nguyen and Schlossman: Stability Study of Avobenzone With Inorganic Sunscreens. Kobo Products, Inc. Available at https://www.scribd.com/document/499910109/10-1-1-738-6177# Last viewed November 16, 2023.
28. Bredholt K, Christensen T, Hannevik M, et al. [Effects of sunscreening agents and reactions with ultraviolet radiation] Tidsskr Nor Laegeforen. 1998 Jun 30;118(17):2640-5.
29. DiNardo JC, Downs CA. Fall from GRASE: The Sunsetting of the Sunscreen Innovation Act. American Journal of Dermatological Research and Reviews. 2021, 4:39. Available at https://escipub.com/Articles/AJODRR/AJODRR-2020-12-2805.pdf - Last viewed November 16, 2023.
30. Siegel RL, Miller KD, Fuchs HE and Jemal A. Cancer Statistics, 2018. CA Cancer J Clin. 2018;68(1):7-30..
31. Siegel RL, Miller KD, and Jemal A. Cancer Statistics, 2019. CA Cancer J Clin. 2019;69(1):7-34.
32. Siegel RL, Miller KD, and Jemal A. Cancer Statistics, 2020. CA Cancer J Clin. 2020;70(1):7-30.
33. Siegel RL, Miller KD, Fuchs HE and Jemal, A. Cancer Statistics, 2021. CA Cancer J Clin. 2021;71(1):7-33.
34. Siegel RL, Miller KD, Fuchs HE and Jemal, A. Cancer Statistics, 2022. CA Cancer J Clin. 2022;72(1):7-33.
35. Siegel RL, Miller KD, Fuchs HE, Wagle NS, and Jemal, A. Cancer Statistics, 2023. CA Cancer J Clin. 2023;73(1):17-48.
36. Stasko T and Hanlon AM. Epidemiology and risk factors for skin cancer in solid organ transplant recipients. UpToDate: Available at https://www.uptodate.com/contents/epidemiology-and-risk-factors-for-skin-cancer-in-solid-organ-transplant-recipients#:~:text=Predictors%20of%20post%2Dtransplant%20skin,%25%20CI%202.12%2D3.21. Last viewed November 16, 2023.
37. Guy Jr GP, Machlin SR, Ekwueme DU, and Yabroff KR. Prevalence and Costs of Skin Cancer Treatment in the U.S., 2002–2006 and 2007–2011. Am J Prev Med. 2015;48(2):183-187.