Sometimes, just when I need it, I get a reminder of something that I’d forgotten.
So, what did I forget? When advocating looking at the big picture, I referred to absolute risk of melanoma and the impact of the proposed legislation. I forgot to take another step back and look at the really big picture of all cause mortality. Often in health research, we discover that an intervention to prevent one outcome actually increases other outcomes.
A tweet from @#JWF# reminded me to do this with respect to this specific topic:
Avoidance of sun exposure is a risk factor for all-cause mortality: results from the MISS cohort. J Intern Med 2014; doi: 10.1111/joim.12251, , ,
Researchers enrolled 29,518 women in 1990 and followed them for 20 years using follow-up surveys and linkage to official databases for additional risk factor information and to identify outcomes.
Their conclusion? Women who avoided sun exposure had double the all-cause mortality compared to women with the highest level of sun exposure. Although tanning beds and sun exposure increased risk of malignant melanoma, the overall death rate was greater. In other words, you might not get skin cancer but you’ll die earlier from something else.
I shouldn’t be surprised by this. Some studies of statins for treating high cholesterol show that, while they protect against cardiovascular endpoints like heart attacks and strokes, overall mortality isn’t significantly changed.