Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor
To the Editor: Dr Gallagher and colleagues1 found that broad-spectrum sunscreen attenuated
the development of nevi in children. However, their analysis may significantly
underestimate the benefits of broad-spectrum sunscreen because only an intent-to-treat
analysis was performed in this randomized trial. Table 3 of their article
illustrates that the median reported protected episodes (with sunscreen) in
the control group were almost 90% of those reported in the intervention group.
Gallagher et al essentially report the relative effectiveness of consistent
broad-spectrum sunscreen use compared with a control group derived from a
community with an already high prevalence of sunscreen use. However, it would
be of more interest to estimate the efficacy of sunscreen use as a protective
factor relative to no sunscreen use.
Barzilai D. Efficacy of Sunscreen in Preventing Nevi. JAMA. 2000;284(22):2870. doi:10.1001/jama.284.22.2869