The Skin Cancer Foundation Journal

MAY 2013

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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Page 8 of 103

President's Message Since its founding in 1979, The Skin Cancer Foundation has been educating the public and the medical profession here and abroad about the importance of skin cancer prevention, early detection, and treatment. But despite our ongoing efforts and those of other organizations, skin cancer incidence continues to rise; in the US, the melanoma rate has more than doubled since 1979. Incidence rates for basal cell and squamous cell carcinoma have also climbed dramatically. How can this be? One reason is simply the nature of skin cancer development: most skin cancers result from years of accumulated exposure to ultraviolet (UV) radiation. Thus, people who received large amounts of UV radiation from the sun 30 years ago may only recently have developed skin cancer. Three decades ago, people lay out unprotected in the sun, rarely giving a thought to seeking shade or wearing sun- If we could keep young women out of tanning beds, and convince men to protect themselves, it would go a long way toward reversing the skin cancer epidemic. safe clothing, and few used sunscreen. Even when they did, the sunscreens had very low sun protection factors (SPFs) to flter out the sun's UVB rays and little or no protection against UVA rays. We now know that both cause cancer. Another major reason is the meteoric growth of indoor UV tanning, especially among young people. When I started the Foundation, indoor tanning was new in the US and not widespread. Today, nearly 30 million Americans tan indoors every year; two to three million are teens. Making matters worse, young tanners appear especially vulnerable to skin damage: people who frst use a tanning bed before age 35 increase their risk for melanoma by nearly 90 percent, and also signifcantly raise their risk of nonmelanoma skin cancers. Melanoma rates soared by 800 percent among young women (by far the greater tanning bed users) and 400 percent among young men between 1970 and 2009, coinciding closely with the rapid rise of indoor tanning. Perhaps the most important reason for the continued rise in skin cancers is the lag between knowledge and behavior. While people's knowledge about skin cancer prevention and early detection has vastly increased, sun-protective behaviors have not caught up. This is especially true of men. In a survey conducted this past year by the Foundation and the makers of Banana BoatĀ® and Hawaiian TropicĀ® sunscreens, we learned that nearly half the men in the US did not use sunscreen in the past year, and that 70 percent do not know how to do a skin self-exam or what skin cancer warning signs to look for. The knowledge is out there, but many men just aren't listening. They are paying a price: men over age 50 are more than twice as likely as women to develop and die from melanoma. If we could keep young women out of tanning beds, and convince men to protect themselves, it would go a long way toward reversing the skin cancer epidemic. I am completely convinced this will happen, because so many things are already moving in the right direction. Sunscreens today are far more effective than in the past, with higher SPFs and much better UVA protection; even better broad-spectrum UVB/UVA sunscreens are waiting in the wings, approved in other countries and awaiting FDA approval. In just the past year, the FDA's long-awaited Final Regulations on sunscreens went into effect, ushering in far more stringent standards calling for effective broad-spectrum protection. The FDA also recently issued a proposed order that, if fnalized, would upgrade tanning lamps and sunbeds from a low-risk Class I device (as safe as a tongue depressor) to a moderate-risk Class II device; tanning beds would not be banned for those under age 18, but the machines would require labels warning teens not to use them. This is a development the Foundation vigorously lobbied the FDA for in the past few years. Since our beginnings, we have continually informed the public, the medical profession, and government about the dangers of tanning machines, and the message is fnally getting through, all over the US and around the world; states, territories, and entire countries are banning indoor tanning for minors; some have banned or plan soon to ban cosmetic tanning altogether. We hope that will someday be the case in all countries. We will keep working to make that happen, and to make sure people everywhere not only know about skin cancer prevention and early detection, but also practice them. Once that happens, those rising skin cancer fgures will start declining. President The Skin Cancer Foundation 7

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