RESUMO
Importance: Exposure to UV radiation, especially in childhood, increases skin cancer risk. Objective: To systematically review the evidence on the benefits and harms of behavioral counseling for skin cancer prevention to inform the US Preventive Services Task Force (USPSTF). Data Sources: Cochrane Central Register of Controlled Trials, MEDLINE, and PubMed were searched for studies published from January 2009 to March 31, 2016, for skin cancer prevention and from August 2005 to March 31, 2016, for skin self-examination. Surveillance in targeted publications was conducted through February 14, 2018. Studies included in previous USPSTF reports were reevaluated for inclusion. Study Selection: Fair- and good-quality studies of primary care-relevant behavioral interventions focused on improving skin cancer outcomes, intermediate outcomes, or skin cancer prevention and self-examination behaviors. Data Extraction and Synthesis: Two investigators independently reviewed abstracts and full-text articles and extracted data into evidence tables. Results were qualitatively summarized but not pooled because of heterogeneity of measures. Main Outcomes and Measures: Skin cancer, sunburn, precursor skin lesions, sun protection behaviors, and any harms from interventions. Results: Twenty-one trials in 27 publications were included (N = 20â¯561). No studies assessed skin cancer outcomes in pediatric populations; 1 adult trial (n = 1356) promoting skin self-examination found no significant difference in participants diagnosed with melanoma in the intervention group vs the control group at 12-month follow-up (0 vs 1 diagnosis). There was no consistent improvement in prevention of sunburn for children (3 trials [n = 2508]) or adults (6 trials [n = 3959]). There were small to moderate increases in sun protection behavior in pediatric populations (6 trials [n = 4252]) and adults (12 trials [n = 13â¯099]) and small increases in skin self-examination in adults (11 trials [n = 7771]; odds ratios, 1.16-2.6). One of 3 trials of indoor tanning found an intervention effect; an appearance-focused intervention (n = 430) resulted in a smaller increase in mean indoor tanning sessions at 6 months in the intervention group vs the control group. Harms were rarely reported: 1 trial of skin self-examination (n = 1356) found an increase in skin procedures in the intervention group vs the control group at 6 months (8.0% vs 3.6%, P < .001) but not between 6 and 12 months (3.9% vs 3.3%, P = .50), and 1 trial (n = 217) found no between-group difference in skin cancer worry (28.9% vs 18.4%, P = .16). Conclusions and Relevance: Behavioral interventions can increase sun protection behavior, but there is no consistent evidence that interventions are associated with a reduction in the frequency of sunburn in children or adults and minimal evidence on skin cancer outcomes. Intervention can increase skin self-examination in adults but may lead to increased skin procedures without detecting additional atypical nevi or skin cancers.
Assuntos
Aconselhamento/métodos , Comportamentos Relacionados com a Saúde , Neoplasias Cutâneas/prevenção & controle , Queimadura Solar/prevenção & controle , Adolescente , Adulto , Criança , Humanos , Lesões Pré-Cancerosas/prevenção & controle , Fatores de Risco , Autoexame/efeitos adversos , Pigmentação da Pele , Protetores SolaresRESUMO
El envejecimiento en las personas està asociado a la aparición o aumento de afecciones estomatológicas, entre ellas las alteraciones periodontales, disfunción masticatoria y el càncer bucal, esta última enfermedad es la de mayor incidencia en la población adulta mayor y su prevención ocupa un lugar importante en la atención primaria de salud, por ello se realizó una investigación cuyo objetivo fue determinar las necesidades de aprendizaje relacionadas con el càncer bucal en el Círculo de Abuelos Isla Azul en el año 2007. Se realizó una investigación de desarrollo tecnológico, descriptiva, de corte transversal para el diagnóstico educativo. Se aplicó una encuesta a 26 ancianos y se determinaron las necesidades de aprendizaje mediante el modelo de David Leyva. El 73 por ciento de los encuestados obtuvo calificación deficiente. Se encontró bajo nivel de conocimiento de los factores de riesgo del càncer bucal, deficiencias en las vías de información educativa, desconocimiento de los síntomas y signos de alarma ante el càncer bucal. No realizaban adecuadamente el autoexamen bucal, por lo que consideramos que existieron necesidades de aprendizaje sobre prevención del càncer bucal en todos los aspectos explorados(AU)
Aging in persons it is associated with appearance or increase of stomatologic affections including the periodontal alterations, mastication dysfunction and oral cancer, this entity with the great incidence in elderlies and its prevention is a priority in Health Primary Care, thus, we conducted a research in elderlies linked to a grandparent home whose objective was to determine the learning needs related to oral hygiene in above mentioned home in 2007. A technological development, descriptive and cross-sectional research to an educational diagnosis. A survey was applied in 26 elderlies determining the learning needs by David Leyva Form. The 73 percent of person polled had a qualification of deficient. In he above mentioned home we found a knowledge low level on oral cancer risk factors, the deficiencies in ways of educational information, lack of knowledge on alarming symptoms and signs in face of or oral cancer and that they not underwent the oral examination, thus considering that there are learning needs on oral cancer prevention in all features explored(AU)
