The Skin Cancer Foundation Journal

MAY 2014

The 2012 edition of The Skin Cancer Foundation Journal features medically reviewed, reader-friendly articles such as tanning, the increasing incidence of skin cancer diagnoses among young women, & the prevalence of melanoma among white males over 50.

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S K I N C A N C E R F O U N D A T I O N J O U R N A L 66 sunscreens, but to sun-safe clothing, shade devices, and UV- blocking window f lms and window glass, among other protective strategies. But too few people use them, and those who do often do so irregularly and inadequately. The U.S. Centers for Disease Control and Prevention estimate that less than a third of adults usually apply sunscreen, only 41 percent wear truly sun-protective clothing, and less than a third report seeking shade. 11 Other studies show that people apply far less sunscreen than required to achieve the SPF on the label, and fail to reapply after two hours in the sun. Is it surprising, then, that a third of the US population reports suf- fering at least one sunburn in the past 12 months? 12 One problem, even in an era more enlightened about skin cancer, is simple vanity. Many young people, especially, think they look better tan, or more importantly, that their peers think they look better tan. They cling to the notion that a tan makes them look younger and healthier, though the very act of tanning is unhealthy and aging; more than 90 percent of the visible skin changes we usually attribute to skin aging are actually caused by UV damage. 13 Pale- skinned stars such as Anne Hathaway and Scarlett Johansson have learned this, and protect their skin to protect their careers, but many young people keep on tanning, even when they know they are put- ting themselves at risk. Their looks today are more important than their long-range health. Another harmful belief is that most sun damage occurs before age 18 and that for adults "the damage is already done," which leads to laxity about sun protection in older adults – especially men. Actually, less than 25 percent of our lifetime sun exposure occurs be- fore age 18; 14 adults over age 40, espe- cially men, have the highest annual ex- posure to UV, and need to continue to protect themselves. 12 Many people also think they have to protect themselves only in summer, but UVA intensity is strong year-round. Signs exist, nonetheless, that things are moving in the right direction. In fact, part of the increased incidence of skin cancers is actually a positive – greater aware- ness of the disease has led people to check their skin for lesions and see physicians for professional skin exams more often. We are thus f nding skin cancers at an earlier stage, when they are more readily treatable. So, more skin cancers are being found, but lives are being saved: survival with melanoma has dramatically improved, from 49 percent in 1950-1954 to 92 percent in 1996-2003. 15 [See Figure 1.] The market for sunscreens, sun-protective clothing, shade devices and window f lms has been going up. Multiple states have passed legislation monitoring the safety of tan- ning salons and limiting minors' access. And an encouraging if not earthshaking result has been seen: while melanoma incidence is still going up, the annual increase in incidence has slowed; it was 6.1 percent from 1975 to 1981 but de- creased to a 1.6 percent increase from 1996 to 2005. 16,17,18,19 [See Figure 1.] If we can build on these encouraging trends, in the near future we could see both incidence and mortality going down signif cantly. Health "One problem, even in an era more enlightened about skin cancer, is simple vanity. Young people cling to the notion that a tan makes them look younger & healthier..." 20 10 5 1 Annual rate per 100,000 persons 0.2 1975 1985 Year of diagnosis Male incidence Male mortality rate Female incidence Female mortality rate 1995 2005 20 10 5 1 Annual rate per 100,000 persons 0.2 1975 1985 Year of diagnosis 1995 2005 Trends in melanoma incidence and mortality among young adults. Age-adjusted (to 2000 US population) annual cutaneous melanoma incidence and mortality rates among Caucasian males and females aged 15-39 years in the Surveillance, Epidemiology, and End Results Program Areas from 1973 through 2004. Reprinted by permission from Macmillan Publishers Ltd: Journal of Investigative Dermatology, Vol 128 Issue12 Copyright 2008 Figure 1 References available on p.97

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