Health Topics
Skin Cancer

	PFD FORMAT The Burden of Skin Cancer [pdf 110K]

The Burden of Skin Cancer

Exposure to the sun's ultraviolet (UV) rays appears to be the most important environmental factor in developing skin cancer. This makes skin cancer a largely preventable disease when sun protective practices and behaviors are consistently applied and used. UV rays from artificial sources of light, such as tanning beds and sun lamps are just as dangerous as those from the sun, and should also be avoided. Unfortunately, despite the fact that both tanning and burning can increase one's risk of skin cancer, most Americans do not protect themselves from UV rays.

Effective sun protection is practiced by less than one-third of U.S. youth. In a recent survey by the American Cancer Society of youth aged 11–18 years, routinely practiced sun-protection behaviors among young people on sunny days were wearing sunglasses (32%) or long pants (21%), staying in the shade (22%), and applying sunscreen (31%). Fifty-eight percent of those using sunscreen, used sunscreen with sun protection factor (SPF) of 15 or more when at the beach or pool.²

A recent survey of parents of children under 12 years found that approximately 43% of white children experienced at least one sunburn in the past year.³ As a result of the growing concern about the importance of minimizing UV exposure during childhood and the rising incidence of skin cancer, the U.S. Centers for Disease Control and Prevention developed the Guidelines for School Programs to Prevent Skin Cancer to help state and local education agencies and schools promote safety and help schools be safe places to learn.

Who Is at Risk?

Although anyone can get skin cancer, individuals with certain risk factors are particularly susceptible.

The following increase a person’s risk of developing skin cancer:

• Light skin color, hair color or eye color
• Family history of skin cancer
• Personal history of skin cancer
• Chronic exposure to the sun
• History of sunburns early in life
• Certain types and a large number of moles
• Freckles, which indicate sun sensitivity and sun damage⁴

Preventing Skin Cancer: Sun Protection Options

People can take many simple steps to plan ahead and protect themselves from the sun’s UV rays. These options are important to remember all year round and during all outdoor activities, and not just when at the beach or pool.

	SEEK SHADE Because the sun’s UV rays are strongest and do the most damage during midday, outdoor activities should be avoided at this time. If this is not possible, then finding the shade of a tree, beach umbrella, or tent is a practical way to protect the skin.
	COVER UP A shirt, beach cover-up, or pants are all good choices. However, a typical shirt actually has a sun protection factor (SPF) rating substantially lower than the recommended SPF 15, so it is wise to double up on protection by using sunscreen with at least sun protection factor SPF 15 and stay in the shade when possible.
	GET A HAT The head and neck are common sites for skin cancers to occur, so a wide-brimmed hat should be worn to shade the face, ears, scalp, and neck from the sun's UV rays. A hat with a four-inch brim provides the most protection. If a baseball cap is worn, sunscreen with a sun protection factor (SPF) of at least 15 should also be used to protect the ears and neck.
	GRAB SHADES Sunglasses protect the tender skin around the eyes and reduce the risk of developing cataracts. Look for sunglasses that block as close to 100% of both UVA and UVB rays. Wraparound lenses are ideal because they keep UV rays from hitting the sides of the eyes.
	RUB IT ON Sunscreen with SPF 15 or higher and both UVA and UVB protection should be used whenever a person spends time outdoors. To be effective, sunscreen needs to be generously applied 30 minutes before going outdoors and reapplied after swimming or sweating.5

CDC's National Leadership Efforts

• Collecting and Applying Vital Information — CDC develops epidemiological research and monitoring systems to determine national trends in sun protection behaviors and attitudes about sun exposure. Findings are used to better target and evaluate skin cancer prevention efforts. CDC and other federal agencies are also helping the independent Task Force on Community Preventive Services review studies of population-based interventions to prevent skin cancer. Recommended interventions will be published in the Guide to Community Preventive Services. This guide will help communities make better use of available scientific information as they plan and implement interventions to prevent skin cancer.
   
• CDC’s Guidelines for School Programs to Prevent Skin Cancer — released April 26, 2002, in the Morbidity & Mortality Weekly Report.  Overall, the guidelines emphasize the following:
   
  1. skin cancer is the most common type of cancer, and new cases and deaths from its deadliest form have been increasing dramatically;
  2. exposure to the sun during childhood and adolescence typically plays a critical role in developing skin cancer;
  3. to be most effective and efficient, school-based approaches to skin cancer prevention should be implemented as part of a coordinated school health program, because no single strategy in isolation can solve the problem;
  4. schools can do a variety of things to prevent skin cancer such as creating supportive, caring environments that make skin cancer prevention a priority.
      
• Getting the Message Out — CDC will launch the fifth year of its Choose Your Cover skin cancer public education campaign on Memorial Day weekend, the unofficial start of summer. The campaign urges teens and young adults to play it safe when outdoors and protect their skin from the sun's harmful UV rays. Campaign messages are delivered through upbeat radio and television public service announcements (PSAs) that are geared to teens and young adults — two groups that spend hours in the sun and are among the least likely to protect themselves. The campaign emphasizes that young people can protect their skin while still having fun outdoors by choosing five sun protection options: Seek shade, especially during midday when UV rays are strongest and do most damage; cover up with clothing to protect exposed skin; get a hat with a wide brim to shade the face, head, ears, and neck; grab shades that wrap around and block as close to 100 percent of both UVA and UVB rays as possible; and rub on sunscreen with SPF 15 or higher and both UVA and UVB protection. For more information visit the Choose Your Cover Web site http://www.cdc.gov/chooseyourcover.
   
• Building Critical Partnerships — CDC has convened the National Council on Skin Cancer Prevention*, an alliance of organizations that share the goals of:
   
  1. increasing skin cancer awareness and prevention behaviors in all populations, particularly those at high risk;
      
  2. developing and supporting partnerships to extend and reinforce core messages for behavioral change;
      
  3. coordinating national efforts to reduce skin cancer incidence and deaths;
      
  4. developing a national skin cancer prevention and education plan. CDC has also convened a Federal Council on Skin Cancer Prevention to promote sun-safe behaviors among federal employees, their families, and agency constituents.
      
• Examples of Programs in Action — CDC fostered the development of two coalitions and two intervention programs that target children, parents, and caregivers to reduce illness and death from skin cancer. These projects included:
   
  • Pool Cool*
     
  • The Sunwise Stampede*
     
  • The National Coalition for Skin Cancer Prevention in Health, Physical Education, Recreation and Youth Sports*
     
  • The Coalition for Skin Cancer Prevention in Maryland*

References

1. American Cancer Society. Cancer facts and figures 2002. Atlanta, GA: American Cancer Society, 2002.
    
2. Cokkinides VE, Johnston-Davis K, Weinstock M, O’Connell MC, Kalsbeek W, Thun MJ, Wingo PA. Sun exposure and sun-protection behaviors and attitudes among U.S. youth, 11 to 18 years of age. Prev Med 2002;33(3):141–51.
    
3. Hall HI, McDavid K, Jorgensen CM, Kraft JM. Factors associated with sunburn in white children aged 6 months to 11 years. Prev Med 2001;20(1):9–14.
    
4. Armstrong BK, English DR. Cutaneous malignant melanoma. In: Schottenfeld D, Fraumeni JF, eds. Cancer epidemiology and prevention. 2nd ed. New York: Oxford University Press, 1996.
    
5. Centers for Disease Control and Prevention. Choose Your Cover. Available at http://www.cdc.gov/chooseyourcover (Accessed March 2002).
    

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Page last reviewed: October 28, 2008
Page last modified: October 28, 2008
Content source: National Center for Chronic Disease Prevention and Health Promotion, Division of Adolescent and School Health

Division of Adolescent and School Health
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention
Department of Health and Human Services