Melanoma: prevention and early detection.

Exposure to ultraviolet radiation is the main modifiable risk factor for melanoma. Strong epidemiologic and molecular evidence links sun exposure to the development of melanoma. Given the ubiquitous abundance of ultraviolet radiation, prevention aimed at blocking sun exposure is recommended by the American Academy of Dermatology, the Skin Cancer Foundation, the American Cancer Society, the Centers for Disease Control, and the Environmental Protection Agency. However, in contrast to other forms of skin damage, controversial data regarding sunscreen use and increased melanoma risk, possibly secondary to more overall sun exposure in melanoma patients, requires clarification. Primary care physicians may not be as adept at identifying worrisome lesions, but they have more opportunity to make the diagnosis. False positive identification of lesions and biopsy does not lead to extreme morbidity. Counseling patients to perform self skin examinations also contributes to important early detection.