Behavioral counseling to prevent XXXX : a systematic review for the U.S. Preventive Services Task Force.

@entity1 @entity1489 @entity957 @entity320 @entity1491
BACKGROUND: More than 2 million cases of @entity1489 are diagnosed annually in the United States, and @entity320 incidence is increasing. PURPOSE: To assist the U.S. Preventive Services Task Force in updating its 2003 recommendation on behavioral counseling to prevent @entity1489 . DATA SOURCES: Existing systematic reviews, database searches through February 2010, and outside experts. STUDY SELECTION: English-language, primary care-relevant counseling trials to promote sun-protective behaviors and studies examining the association between sun-protective behaviors and @entity1489 outcomes or potential adverse effects were included. DATA EXTRACTION: Each study was appraised by using design-specific quality criteria. Important study details were abstracted into evidence tables. DATA SYNTHESIS: 11 fair- or good-quality, randomized, controlled trials examined the counseling interventions' effect on sun-protective behaviors. In young @entity1 , appearance-focused behavioral interventions decrease indoor tanning and ultraviolet exposure. In young adolescents, computer support can decrease midday sun exposure and increase sunscreen use. Thirty-five mainly fair-quality observational studies examined the relationship between ultraviolet exposure or sunscreen use and @entity1489 . Increasing intermittent sun exposure in childhood is associated with an increased risk for @entity957 , @entity1491 , and @entity320 . Evidence suggests that regular or early use of indoor tanning may increase @entity320 risk. On the basis of 1 fair-quality trial, regular sunscreen use can prevent @entity957 , but it is yet unclear if it can prevent @entity1491 or @entity320 . LIMITATIONS: There are limited rigorous counseling trials. Observational studies are limited by the complexity of measuring ultraviolet exposure and sunscreen use, and inadequate adjustment for important confounders. CONCLUSION: Randomized, controlled trials suggest that primary care-relevant counseling can increase sun-protective behaviors and decrease indoor tanning.
