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Health Topics
Skin Cancer
The Burden of Skin Cancer
Skin cancer is the most common form of cancer in the United States — more
than one million new cases of skin cancer will be diagnosed in 2002. The
incidence of malignant melanoma, one of the deadliest forms of skin
cancer, has more than doubled between 1973 and 1996. Melanoma is more
common than any non-skin cancer among people between 25 and 29 years old.
An estimated 7,400 deaths from melanoma and 2,200 from other skin cancers
are expected in 2002. The three major types of skin cancer are basal cell
carcinoma, squamous cell carcinoma, and melanoma. Basal cell and squamous
cell carcinomas can cause substantial illness and, untreated, can cause
considerable damage and disfigurement. A cure is highly likely, however,
if detected and treated early. Malignant melanoma causes more than 75% of
all deaths from skin cancer. This most serious form of skin cancer can
spread to other parts of the body quickly. When detected in its earliest
stages and treated properly, however, it is highly curable. For localized
melanoma, the 5-year relative survival rate is 96%; survival rates for
regional and distant stage diseases are 61% and 12%, respectively.1
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.
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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.
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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.
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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. |
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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.
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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
CDC’s skin cancer prevention and education efforts are designed to
reduce illness and death, and help achieve the Healthy People 2010 skin
cancer prevention goal: Increase to at least 75% the proportion of adults
who regularly use at least one sun protection option, limit sun exposure,
and use sunscreen. To help achieve this goal, CDC supports the following
activities to prevent skin cancer:
- 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.
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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:
- skin cancer is the most common type of cancer, and new cases and deaths
from its deadliest form have been increasing dramatically;
- exposure to the sun during childhood and adolescence typically plays a
critical role in developing skin cancer;
- 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;
- 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:
- increasing skin cancer awareness and prevention behaviors in all
populations, particularly those at high risk;
- developing and supporting partnerships to extend and reinforce core
messages for behavioral change;
- coordinating national efforts to reduce skin cancer incidence and
deaths;
- 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:
References
- American Cancer Society. Cancer facts and figures
2002. Atlanta, GA: American Cancer Society, 2002.
- 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.
- 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.
- 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.
- Centers for Disease Control and Prevention. Choose
Your Cover. Available at
http://www.cdc.gov/chooseyourcover (Accessed March 2002).
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