Sun Exposure and Skin Cancer: A Narrative Review of Risk Factors, Prevention Behaviors, and Emerging Therapeutic Approaches

Abstract

Ultraviolet radiation is a well-established carcinogen associated with cutaneous neoplasms and represents one of the main modifiable risk factors for the development of skin tumors. Despite widespread recognition of the harmful effects of excessive sun exposure, gaps persist between public awareness and the effective adoption of preventive measures. This study aims to synthesize the scientific evidence regarding the relationship between sun exposure and skin cancer, addressing risk quantification, photoprotective behaviors, public misconceptions, and emerging therapeutic innovations for advanced cases. This narrative review is based on the analysis of six studies examining different aspects of the relationship between sun exposure and skin cancer, including meta-analyses, economic evaluations, and behavioral research. Findings demonstrate significantly increased odds of cutaneous squamous cell carcinoma associated with painful lifetime sunburns, particularly when burns occur during childhood (OR 3.11). Although awareness of ultraviolet radiation risks is generally adequate, photoprotective behaviors remain insufficient among both athletes and the general population. Misconceptions persist regarding sunscreen use in higher phototypes, vitamin D production, and the benefits of high-SPF formulations. Preliminary, albeit limited, evidence suggests a low carcinogenic risk associated with UV lamps used in gel manicures. Economic evaluations indicate highly favorable returns on investment for primary prevention programs, ranging from US$0.35 to €3.60 per monetary unit invested. In the therapeutic field, c-Kit inhibitors demonstrate objective response rates of 15% in advanced melanomas harboring KIT mutations, with nilotinib showing a response rate of 20%. Plant-derived polyphenols emerge as promising ingredients for photoprotective formulations, with significant correlations between phenolic content, antioxidant activity, and sun protection factor (SPF). This review highlights the persistent gap between awareness of sun exposure risks and effective adoption of photoprotective measures, reinforcing the need for more effective public health strategies. The cost-effectiveness of primary prevention initiatives, combined with the development of novel therapeutic options and photoprotective ingredients, underscores the importance of continuous innovation in both prevention policies and clinical management of cutaneous neoplasms.