Skin Cancer Prevention in Action

Skin Cancer Prevention in Action: The Latest National Updates from CDC

Authors:

Meg Watson (Presenter)
Centers for Disease Control and Prevention

Dawn Holman, Centers for Disease Control and Prevention

Public Health Statement: In 2014, the U.S. Surgeon General released a Call to Action to Prevent Skin Cancer (CTA), identifying skin cancer as a major public health problem in the United States.

Purpose: This presentation will describe CDC’s skin cancer prevention efforts and highlight new data since the release of the CTA.

Methods/Approach: CDC uses surveillance data to monitor melanoma incidence and mortality as well as skin cancer risk factors. CDC also conducts applied research, communicates accurate and timely information to the public and partners, and provides technical support to those putting skin cancer prevention into action in their communities.

Results: National data suggest recent improvements as well as some ongoing concerns. Data from the 2015 National Health Interview Survey (NHIS) indicate increases in the percentage of adults using shade (39.1%) and sunscreen (33.7%) and decreases in the percentage indoor tanning (3.5%). Similarly, data from the 2015 national Youth Risk Behavior Survey (YRBS) indicate that the percentage of high school students who use indoor tanning devices (7.3%) has decreased significantly since 2013. Sunburn continues to be common, with about one-third of adults and over half of high school students getting sunburned each year (2015 NHIS and YRBS, respectively). Melanoma incidence has continued to increase among whites of all ages (United States Cancer Statistics).

Conclusions/Implications: Public health efforts have led to substantial reductions in indoor tanning. Ongoing work is needed to identify and implement evidence-based strategies to further reduce intentional tanning, and to ensure that children and adults of all ages are adequately protected from overexposure while outdoors.

Skin Cancer Prevention in Action: Ray and the Sunbeatables™: An Evidence-Based Sun Safety Curriculum for Young Children

Authors:

Mary Tripp (Presenter)
The University of Texas MD Anderson Cancer Center

Payal Pandit Talati, The University of Texas MD Anderson Cancer Center
Elizabeth Burton, The University of Texas MD Anderson Cancer Center
Jeffrey Gershenwald, The University of Texas MD Anderson Cancer Center
Susan Peterson, The University of Texas MD Anderson Cancer Center

Public Health Statement: About 5 million people are treated annually for skin cancer, the most common cancer in the U.S. Overexposure to the sun during childhood increases lifetime risk of skin cancer. Schools play a critical role through educational programming and implementation of policies and practices to reduce students’ sun exposure.

Purpose: This presentation will describe the development, dissemination and implementation of Ray and the Sunbeatables, an evidence-based sun safety curriculum for young children.

Methods/Approach: Sunbeatables launched in May 2015 as part of the Melanoma Moon Shot Program at The University of Texas MD Anderson Cancer Center. Sunbeatables includes teacher training, teacher’s guide and curricula, parent communications and school policy guidance. Lessons are aligned to national educational standards. Sunbeatables has been disseminated through a partnership between MD Anderson and CATCH Global Foundation. After launching Sunbeatables for pre-kindergarten/preschools, MD Anderson collected interview and observational data at Houston-area pilot implementation sites to inform refinements of program content, which launched in Spring 2016. MD Anderson developed and piloted expanded curriculum content for kindergarteners and first-grade students, launching the K-1 program in Fall 2016.

Results: Sunbeatables has been disseminated to over 1,000 sites across 23 states and one Canadian province, reaching over 100,000 children. Preschool research showed that core sun safety concepts were taught in most observed lessons. Teachers adapted lessons to address limited preparation time and unique classroom needs. Organizational capacity, including school leadership, staffing, parent engagement, material resources and approaches to integrating new curricula, emerged as important to Sunbeatables implementation.

Conclusions/Implications: Ongoing evaluation and digitization of the Sunbeatables program will enable further content refinement and scalability. Designing and evaluating implementation strategies to facilitate integration of Sunbeatables with existing school and community programs will enhance successful implementation, to reduce sun exposure in children and realize the public health impact of reduced skin cancer incidence.

Skin Cancer Prevention in Action: Empowering Public Policymakers to Make Informed Decisions Regarding the Dangers of Indoor Tanning: The University of Texas MD Anderson Cancer Center (MDACC) and American Cancer Society Cancer Action Network (ACS-CAN) Indoor Tanning Legislation Experience

Authors:

Jeffrey Gershenwald (Presenter)
The University of Texas MD Anderson Cancer Center

Elizabeth Burton, The University of Texas MD Anderson Cancer Center
Mark Moreno, The University of Texas MD Anderson Cancer Center
Mary Tripp, The University of Texas MD Anderson Cancer Center
Carter Steger, American Cancer Society Cancer Action Network

Public Health Statement: Indoor tanning among youth is associated with increased risk of melanoma, the most deadly form of skin cancer. Protecting youth by restricting access to indoor tanning is aligned with strategic goals of the 2014 U.S. Surgeon General’s Call to Action to Prevent Skin Cancer and Healthy People 2020 initiatives.

Purpose: To highlight MDACC/ACS-CAN collaboration aimed at reducing youth exposure to indoor tanning devices through statewide legislative initiatives.

Methods/Approach: In 2013, the MDACC Melanoma Moon Shot served as a clinical and scientific resource to Texas legislators regarding indoor tanning risks. Texas became the 4^th state to prohibit indoor tanning by minors. In an effort to leverage this experience, MDACC partnered with ACS-CAN to expand clinical and scientific resources to stakeholders interested in pursuing indoor tanning legislation in other states by providing background scientific information/expert testimony, developing timely communication and evidence-based opinion pieces for targeted publication, and facilitating connections among stakeholders, including clinician expert colleagues, care affiliates, and institutional philanthropic board members.

Results: To date, 15 states and Washington, DC have passed legislation. MDACC and ACS-CAN together have engaged with key stakeholders in several of these states. Since 2013, ACS-CAN has continued to engage with stakeholders in several states seeking to introduce similar legislation, and MDACC has served as a networking partner and subject matter clinical and scientific resource. Compliance research performed by MDACC demonstrated that 81% of evaluated Texas facilities offering indoor tanning were compliant with the Texas legislation restricting minors’ access. According to the 2015 CDC Youth Risk Behavior Survey (YRBS), reported use of indoor tanning devices by U.S. high school students decreased to 10.6% and 4.0%, respectively, among females and males, representing a significant reduction from 2013.

Conclusions/Implications: Academic medical institution-medical/advocacy society partnerships can help promote and support informed decision-making in efforts to reduce youth exposure to indoor tanning. Coupled with encouraging indoor tanning trends from CDC’s YRBS, such efforts can meaningfully contribute to reducing the public health burden of skin cancer.

Skin Cancer Prevention in Action: Teaching Youth at Schools and Pools Why Tans Aren’t Cool

Author:

Vicky Jekich (Presenter)
St. Luke’s Mountain States Tumor Institute

Public Health Statement: The death rate of melanoma is higher in Idaho than the U.S. overall and the incidence of melanoma over the last 5 years has increased. Idaho also has a higher percentage of youth using artificial sources of UV light for tanning than the U.S. Many behaviors that contribute to increased cancer risk begin during adolescence. Healthy lifestyles established early may lower rates of cancer in years to come.

Purpose: The presentation will highlight St. Luke’s MSTI’s skin cancer prevention programs designed to increase awareness, motivation and UV protection practices among junior high and high school students, along with young adults who teach children at local swimming pools.

Methods/Approach: St. Luke’s MSTI developed skin cancer prevention programs that supported community health needs assessment, statewide comprehensive cancer strategic plan goals and State health education content standards for health promotion and disease prevention. Interactive sun safety classroom lesson plans and the evidence-based POOL COOL program were implemented, with pre-post surveys and evaluations gathered to identify knowledge transfer and behavioral intentions.

Results: Presentations reached nearly 7,000 students, over 400 swimming pool staff and over 10,000 young children participating in swim lessons. Student surveys and training evaluations indicated students and pool staff improved their sun safety knowledge and would use additional sun safe behaviors.

Conclusions/Implications: Educational efforts aimed at school-age students, and young adults who work at swimming pools have increased awareness of skin cancer risks and improved healthy behaviors. The programs have also led to skin cancer prevention educational opportunities to other groups including athletes, marketing students, junior lifeguards, and Mommy & Me class participants. Efforts should continue and expand to youth groups and activities (e.g. cheerleading and proms) that can increase skin cancer risks through indoor tanning.