What CDC Is Doing About Skin Cancer

The Centers for Disease Control and Prevention (CDC) provides leadership for nationwide efforts to reduce illness and death caused by skin cancer, which is likely the most common form of cancer in the United States.

Accomplishments

These and other public health efforts that address skin cancer support CDC's overarching goal of healthy people in every stage of life. They also address the U.S. Department of Health and Human Services' Healthy People 2010 goals of increasing the proportion of people who use at least one sun-protective measure that may reduce the risk of skin cancer, and reducing the rate of melanoma cancer deaths to 2.5 deaths per 100,000 people.

Measures for Sunless Tanning Use

In December 2005, CDC and a group of skin cancer experts met to discuss common measures of sun protection and tanning behaviors, with an aim of developing a consensus-based set of core items to measure indoor and sunless tanning use. After reaching a consensus, the core measures were cognitively tested and revised. The recommendations were published in the February 2008 edition of the Archives of Dermatology.^{1 2}

Strategies for Preventing Skin Cancer

CDC worked with other federal agencies and the independent Task Force on Community Preventive Services to review studies of community-based interventions targeting skin cancer prevention. Recommended interventions are published in the Guide to Community Preventive Services Web site.^{3 4 5 6 7}

Research Articles

CDC has published significant research on skin cancer.

School Guidelines

The 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.

Shade Planning Manual

The Shade Planning for America's Schools (PDF-1.2MB) manual helps schools ensure school grounds have adequate shade, which is part of the Guidelines for School Programs to Prevent Skin Cancer.

Model Policy Language

In partnership with CDC's Division of Adolescent and School Health and other collaborators, the National Association of State Boards of Education (NASBE) developed research-based, best practice model policy language on various school health topics that states, districts, and schools can adopt or adapt for themselves. Policies to Promote Sun Safety and Prevent Skin Cancer provides direction on establishing an overall policy framework for school health programs and specific policies on various topics.

Sun Safety Report

In 2002, NASBE published the report, "Fit, Healthy, and Ready to Learn: Sun Safety." Developed with funding from CDC's Division of Adolescent and School Health, it is designed to help state and local decision makers establish effective policies to help students adopt and maintain lifelong sun safety habits.

Ongoing Work

CDC's skin cancer prevention and education efforts include—

• Funding cancer programs in nine states to implement skin cancer activities outlined in the states' Comprehensive Cancer Control (CCC) plans, through the National Comprehensive Cancer Control Program. With a total award of $475,000, these states are increasing awareness and educating children and adolescents, as well as establishing school policies based on the recommendations of Guidelines for School Programs to Prevent Skin Cancer (Guidelines). Accomplishments include the development of—
  • Sun safety questions incorporated into the state Behavioral Risk Factor Surveillance System (BRFSS).
  • Elementary school education kits to integrate skin cancer education into current classroom lessons.
  • Partnerships with the Parent-Teacher Association (PTA), Environmental Protection Agency (EPA), Young Men's Christian Association (YMCA), American Cancer Society (ACS), state school nurses' associations, pharmaceutical companies, state CCC coalitions, and dermatological societies.
  • Media campaigns.
  • Mini-grants to schools for shade shelters.
  • A foundation for a sun safety program across several counties in one state to develop curriculum and policies for schools, pools, camps, and beaches.
• Analyzing data collected from a pilot program with three states. The states' education agencies collaborated with the states' departments of health to conduct demonstration projects implementing the Guidelines. Lessons learned for possible replication in other states will be reported to CDC.
• Supporting epidemiologic, behavioral science, and surveillance research efforts designed to expand knowledge about skin cancer prevention and control.

CDC supports the following data collection efforts—

• Youth Risk Behavior Surveillance System (YRBSS)
• Behavioral Risk Factor Surveillance System (BRFSS)
• National Health Interview Survey (NHIS)

Future Directions

CDC's skin cancer prevention education initiative plans to—

• Enhance prevention research to identify effective strategies for reducing skin cancer risk.
• Increase support of skin cancer activities described in states' CCC plans. Specifically, CDC's National Comprehensive Cancer Control Program will fund selected states with approved skin cancer activities.
• Promote, disseminate, and support the implementation of the Guidelines for School Programs to Prevent Skin Cancer.
• Continue surveillance on monitoring sun-protective behaviors among the U.S. population.
• Consider the feasibility of a monograph on the descriptive epidemiology of melanomas in the United States.

References

¹Lazovich D, Stryker JE, Mayer JA, Hillhouse J, Dennis LK, Pichon L, Patago S, Heckman C, Olson A, Cokkinides V, Thompson K. Measuring nonsolar tanning behavior. Archives of Dermatology 2008;144(2):225–230.

²Glanz K, Yaroch AL, Dancel M, Saraiya M, Crane LA, Buller DB, Manne S, O’Riordan DL, Heckman CJ, Hay J, Robinson JK. Measures of sun exposure and sun protection practices for behavioral and epidemiologic research. Archives of Dermatology 2008;144(2):217–222.

³Saraiya M, Glanz K, Briss PA, Nichols P, White C, Das D, Smith SJ, Tannor B, Hutchinson AB, Wilson KM, Gandhi N, Lee NC, Rimer B, Coates RC, Kerner JF, Hiatt RA, Buffler P, Rochester P. Interventions to prevent skin cancer by reducing exposure to ultraviolet radiation: a systematic review. American Journal of Preventive Medicine 2004;27(5):482–483.

⁴Glanz K, Buller, DB, Saraiya, M. Reducing ultraviolet radiation exposure among outdoor workers: state of the evidence and recommendations. Environmental Health 2007;6(1):22.

⁵Glanz K, Halpern, AC, Saraiya, M. Behavioral and community interventions to prevent skin cancer: What works? Archives of Dermatology 2006;142(3):356–360.

⁶Glanz K, Saraiya M. Using evidence-based community and behavioral interventions to prevent skin cancer: opportunities and challenges for public health practice. Preventing Chronic Disease 2005;2(2):A03.

⁷Saraiya M, Glanz K, Briss P, Nichols P, White C, Das D; Task Force on Community Preventive Services on Reducing Exposure to Ultraviolet Light. Preventing skin cancer: findings of the Task Force on Community Preventive Services on Reducing Exposure to Ultraviolet Light. MMWR Recommendations and Reports 2003;52(RR-15):1–12.