Arizona pharmacists are not particularly well-informed about skin cancer and need to take steps to improve their knowledge, a survey of pharmacists working in a variety of settings found.
Ashley VanAllen, PharmD, and her colleagues at the University of Arizona College of Pharmacy in Tucson, reported the results of questionnaires completed by 110 Arizona-based pharmacists who worked in community pharmacies, longterm care facilities, hospital outpatient pharmacies, managed care pharmacies, and other settings.
"With a maximum possible score of 10, their mean score was only 5.8," said VanAllen, who is currently a pharmacy resident at Health Point in Kent, Washington. "We would have liked to have seen better results, given that Arizona has the highest rate of skin cancer in the United States and ranks number two in skin cancer incidence worldwide, after Australia."
Only 41% of pharmacists were able to identify the active ingredient in sunscreen that provides the best coverage against both ultraviolet-A (UVA) and ultraviolet-B (UVB) spectrums of light. The correct answer is zinc oxide. Additional findings:
- 51% gave a correct response when asked how often a waterproof sunscreen needs to be reapplied after swimming or sweating. The correct answer is every 80 minutes.
- 54% gave a correct response when asked what the ABCD acronym stands for. The correct response is that "A" stands for asymmetry (one half of a mole is different from another), "B" is for border irregularity (the mole has an irregular, notched, and indistinct border), "C" is for color variations (a mole changes in color or shade such as blue, white, brown, black, or a combination of these colors and shades), and "D" is for diameter (a mole is larger than a pencil eraser, a diameter greater than 6 mm).
- 60% answered correctly when asked to identify the minimum recommended sun protection factor (SPF) for adults. The minimum SPF for adults is 15.
- 62% answered correctly when asked about the main factor that determines prognosis/survival with malignant melanoma. The correct response is the depth of the mole in the skin, based on penetration measurement in millimeters.
- 80% knew that the most appropriate time to apply sunscreen containing avobenzone and homosalate for outdoor sunlight exposure. It should be applied 30 minutes before exposure to the sun.
Fewer than half of respondents were able to identify the risk factors for basal and squamous cell carcinoma. Also, although nearly half said they believe that pharmacists can be effective in reducing a patient's risk of skin cancer, fewer than 10% said they were very comfortable with counseling patients about sun safety. "We would hope that Arizona-based pharmacists would be more comfortable counseling patients about sunscreens, given the high incidence of skin cancer in Arizona," VanAllen said.
She also pointed out that although most questions about sunscreen use are from adults with children, she thinks that pharmacists should take a more proactive role in counseling about sunscreen for both adults and children. But first, she added, pharmacists need to be better informed, and there are continuing medical education programs available where they can improve their knowledge.