Are Sunscreens Cost-effective for the Prevention of Skin Cancer?

Craig A. Elmets, MD

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In This Article

Abstract and Introduction

Abstract

A modest investment in prevention produced substantial savings in illness-related costs.

Introduction

Dermatologists routinely recommend regular application of sunscreens to people at risk for developing skin cancer. From a strictly economic standpoint, is the routine use of sunscreens cost-effective for the prevention of nonmelanoma skin cancers and premalignant actinic keratoses (AKs)? To address this issue, investigators employed data collected from a Queensland, Australia, community-based sunscreen prevention trial.

Of 1621 participants, 1383 (85%) remained in the trial for 5 years, 155 of whom developed at least one nonmelanoma skin cancer. Eleven fewer basal cell carcinomas developed in the group of daily sunscreen users than in intermittent users in a control group (94 vs. 105); the regular users also had 24 fewer squamous cell carcinomas (27 vs. 51). An estimated 838 fewer AKs also occurred in the regular users.

Most healthcare in Australia is covered by government insurance. Costs were classified as expenses to government (for managing and treating AKs and skin cancers) or to patient (e.g., cost of time to attend skin exam or apply sunscreen) and healthcare provider (e.g., cost of sunscreen, staff salaries, office expenses). The net cost, over 5 years, for the sunscreen group was US$405 per person, compared with $275 for the control group. Therefore, daily sunscreen use resulted in a savings to the government with a slightly increased cost for the patient and doctor. Assuming that all skin cancers and half of AKs were treated, regular sunscreen use produced an estimated annual per-person savings of $109 in avoided procedures.

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