Cancer Control Research
5R01CA062959-04
Gerbert, Barbara J.
SKIN CANCER PREVENTION
AbstractThe incidence of malignant melanoma and nonmelanoma skin cancer appears
to be increasing at an alarming rate. Many cases of skin cancer could be
prevented if individuals decreased their unprotected exposure to sources
of ultraviolet radiation, such as sunlight and tanning lamps (primary
prevention). If skin cancer does occur, early detection substantially
increases the likelihood of successful treatment (secondary
prevention).While primary and secondary prevention could substantially
decrease the incidence of, and the morbidity and mortality from, skin
cancer, neither are sufficiently practiced.
To improve skin cancer prevention, messages about primary and secondary
prevention practices must be effectively disseminated, one potentially
appropriate avenue being in the setting where people receive their
primary health care. Mass media education about skin cancer is expensive,
and prevention messages are often minimized or ignored because they lack
specificity. Special dermatologic screening clinics pose other
dissemination problems, in that individuals who present to be screened
already practice secondary prevention (i.e., have detected suspicious
lesions). In contrast, if messages about primary and secondary prevention
of skin cancer were incorporated into routine health care, all patients
would be in a position to receive individualized advice and counseling
from an authoritative and trusted source, their physician.
Our study proposes to test the separate and combined effectiveness of two
interventions disseminated through a primary health care setting to
increase primary and secondary prevention of skin cancer. One
intervention will be targeted at primary care physicians, but the other
will be targeted at patients. We will assess which intervention strategy
(Physician-based,Patient-based,or a combination of both) most effectively
decreases patients' unprotected exposure to ultraviolet radiation;
increases the frequency with which patients perform total-body self-
examinations of their skin; increases the frequency with which primary
care physicians counsel patients about primary prevention of skin cancer;
and increases the frequency with which primary care physicians perform
total-body skin examinations of their patients.
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