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Health Topics
Skin Cancer
School Health Guidelines
Summary
Protection from ultraviolet (UV) exposure during childhood and
adolescence reduces the risk for skin cancer in adults. More than 53
million young people spend a substantial proportion of their lives in
schools, and some of that time will be spent outdoors under the sun.
Schools need to be sun-safe places to reduce children’s exposure to UV
radiation. Schools also can teach students the knowledge, motivation, and
skills they need to adopt and maintain sun-safe behaviors for a lifetime.
School-based programs on sun safety are an effective way to teach children
at an early age how to protect themselves and help decrease their risk of
developing skin cancer as adults.
The Burden of Skin Cancer
- Skin cancer is the most common type of cancer in the United States.
The two most common kinds of skin cancer are basal cell carcinoma and
squamous cell carcinoma. Both are highly curable. More than 1 million
cases of basal cell or squamous cell cancers occur annually in the
United States. Melanoma, the third most common type of skin cancer and
one of the most common cancers among young adults, is more dangerous.
- In 2002, an estimated 53,600 persons will be diagnosed with
melanoma. An estimated 9,600 deaths will occur this year from skin
cancer— 7,400 from melanoma and 2,200 from other skin cancers.
- In the United States, diagnoses of new melanomas are increasing,
whereas diagnoses of most other cancers are decreasing. Between 65% and
90% of melanomas are caused by UV radiation.
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How to Prevent Skin Cancer
Skin cancer is largely preventable by limiting exposure to the primary
source of UV radiation: sunlight. Ultraviolet rays are an invisible form
of radiation that come from the sun.
The most effective ways to reduce exposure to sunlight are to:
- Minimize exposure to the sun during peak hours 10 a.m. to 4 p.m.
- Seek shade from the sun.
- Wear clothes and wide-brimmed hats that protect the skin and face.
- Wear wrap-around sunglasses that block close to 100% of UV rays.
- Use a broad-spectrum sunscreen that blocks both UVA and UVB rays and
has a sun protection factor (SPF) of at least 15 or higher. Apply
generously 30 minutes before going outside and reapply after swimming,
exercising, or sweating.
- Avoid using sunlamps and tanning beds. They are also sources of UV
radiation.
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Childhood & Adolescent Ultraviolet (UV) Exposure
- A history of one or more sunburns (an indicator of intense UV
exposure) in childhood or adolescence has been found to increase the
risk of developing basal cell carcinoma and melanoma as an adult.
- Childhood is the most important time for developing moles, an
important risk factor for skin cancer. There is some evidence that sun
exposure in childhood heightens the risk of melanoma by increasing the
number of moles.
- More than half of a person’s lifetime UV exposure typically occurs
during childhood and adolescence.
- Effective sun protection is practiced by less than one-third of U.S.
youth.
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Benefits of
Promoting Sun-safety in Schools
- Behavior changes can be accomplished through classroom lessons, as
well as through school policies and practices related to outdoor
activities.
- Schools can set a powerful example for students, families, and the
entire community by actively promoting sun safety.
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CDC’s
School Guidelines for School Health Programs
CDC’s Guidelines for School Programs to Prevent Skin Cancer were
designed to provide schools with a comprehensive approach to preventing
skin cancer among adolescents and young people. CDC worked with
specialists in dermatology, pediatrics, public health, and education from
universities; national, federal, state, and voluntary agencies; schools;
and other organizations to develop these guidelines. They are based on a
review of research, theory, and current practice in skin cancer
prevention, health education, and public health.
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Key Principles
- Skin cancer is the most common type of cancer, and new cases and
deaths from melanoma, the deadliest form, have been increasing
dramatically.
- Exposure to the sun during childhood and adolescence typically plays
a critical role in the development of skin cancer as an adult.
- To be most effective and efficient, school-based approaches to skin
cancer prevention should be implemented as part of a coordinated school
health program. No single strategy in isolation can solve the problem.
- Schools can do a variety of activities to prevent skin cancer. First
and foremost, schools can create supportive, caring environments that
make skin cancer prevention a priority.
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Recommendations
CDC’s guidelines include seven recommendations for schools from
prekindergarten through the 12th grade and are meant to encourage skin
cancer prevention on school property and elsewhere. The recommendations
are as follows:
- Policy
Establish policies that reduce exposure to ultraviolet (UV) radiation.
- Encourage scheduling of outdoor activities during times when the sun is
not at peak intensity, when possible.
- Modify building and grounds codes to increase availability of shade in
frequently used outdoor spaces.
- Encourage or require students to wear protective clothing, hats, and
sunglasses.
- Establish sunscreen-use routines before going outside.
- Support health education activities needed for skin cancer prevention.
- Disseminate skin cancer prevention information to families.
- Develop guidance for allocation of resources for skin cancer
prevention.
- Environment
Provide and maintain physical and social environments that support sun
safety and are consistent with the development of other healthy habits.
- Consider sun protection in the design of new schools.
- Identify opportunities to extend or create new shaded areas.
- Work with community partners to facilitate provision of sunscreen at
a reduced price or fee.
- Use visual and audio messages to remind students to engage in
sun-safe behaviors.
- Encourage all adults to be sun-safe role models.
- Have peer educators teach students about sun safety.
- Recognize staff and students who practice sun safety.
- Education
 Provide health education to teach students the knowledge, attitudes,
and behavioral skills they need to prevent skin cancer. This education
should be age-appropriate and linked to opportunities for practicing
sun-safe behaviors.
- Include skin cancer prevention as part of a comprehensive health
education curriculum.
- Integrate skin cancer prevention into other subject areas as well.
- Provide skin cancer education sequentially and reinforce key
messages over time, from prekindergarten through 12th grade.
- Deliver skin cancer education during times of the year when
students have the most opportunities for sun exposure and sun
protection.
- Families
Involve family members in skin cancer prevention
efforts.
- Educate parents about the importance of sun-safe behaviors.
- Inform parents about school initiatives and policies and obtain
their input.
- Encourage parents to advocate for sun-safe policies and practices
in the school.
- Professional Development
Include skin cancer prevention knowledge and skills in preservice and
inservice education for school administrators, teachers, physical
education teachers and coaches, school nurses, and others who work with
students.
- Integrate skin cancer prevention into existing professional
development activities.
- Tailor professional development activities to the responsibilities
of the audience.
- Health Services
Complement and support skin cancer
prevention with school health services.
- Include parental permission for use of sunscreen in the health
record.
- Use sports participation checkups to educate students about skin
cancer prevention.
- Assess patients’ sun exposure patterns and reinforce
sun-protective behaviors.
- Advocate for skin cancer prevention policies and practices.
- Evaluation
Periodically evaluate whether schools are implementing the skin
cancer prevention guidelines. They should be evaluated on policies,
environment, education, family involvement, professional development,
and health services.
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For More Information
For additional information or a copy of Guidelines for School
Programs to Prevent Skin Cancer, contact the Division of Cancer
Prevention and Control (DCPC) or the Division of Adolescent and School
Health (DASH), National Center for Chronic Disease Prevention and Health
Promotion, Centers for Disease Control and Prevention at:
http://www.cdc.gov/cancer/nscpep/ or
http://www.cdc.gov/HealthyYouth/contact/index.htm
1-888-842-6355 or
1-888-231-6405
Cancerinfo@cdc.gov or
HealthyYouth@cdc.gov
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