Skin Cancer Prevention

More than 1 million people will be diagnosed with skin cancer this year.Skin cancer is the most common cancer in the U.S., as well as Pennsylvania, and is also the most preventable. When used consistently, sun-protective practices can prevent skin cancer.

According to the Centers for Disease Control and Prevention, 61,646 people in the US were diagnosed with melanomas of the skin in 2009 (the most recent data available). IN 2009, 9,199 people died from melanomas of the skin in the US.*

The two most common types of skin cancer, basal cell and squamous cell carcinoma, are highly curable. Malignant melanoma carcinomas are much more dangerous. In 2009, there were 155 diagnosed cases of skin cancer in Chester County.

Most skin cancer occurs after age 50 but most cases are thought to be from sun damage accumulation starting at a young age. Everyone is at risk for developing skin cancer, yet some people are at a higher risk if they fall into any of the following risk factor categories:
  • Family history of skin cancer
  • Lighter natural skin color
  • Blue or green eyes
  • Blond or red hair
  • Constant exposure to the sun through unprotected work and play
  • A history of sunburns early in life
  • Skin that burns, freckles, gets red easily or becomes painful in the sun
  • Certain types and/or a large number of moles
  • A diagnosis of skin cancer in the past increases the risk of developing it again
Warning Signs
The most common warning sign of skin cancer is a change on the skin, especially a new growth or sore that does not heal. Not all skin cancers are similar in appearance. For example, the cancer may start as a small, smooth, shiny, pale, or waxy lump,or it can appear as a firm red lump. Sometimes, the lump bleeds or develops a crust. Skin cancer can also start as a flat, red spot that is rough, dry, or scaly.

Visual comparisons of moles
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If you notice a mole, you should follow the simple ABCD rule, which outlines the warning signs of melanoma and see your physician:
  • Border irregularity – The edges are ragged, notched or blurred.
  • Color – The pigmentation is not uniform. Shades of tan, brown or black are present. Dashes of red, white, and blue add to the mottled appearance.
  • Diameter – The width is greater than six millimeters (about the size of a pencil eraser). Any growth of a mole should be of concern.
It is important to know the pattern of moles, freckles and blemishes currently on your body. Take the time to examine all areas of your body including palms, soles, scalp, ears, nails and back. Self-exams should be performed monthly so you can monitor any changes.

It is also important to receive yearly skin exams from your dermatologist. A physician will usually first do a visual exam and if anything out of the ordinary is found, he or she may perform a biopsy. A biopsy is when a small sample of the suspicious looking area of the skin is removed for further testing.

Prevention and Protection

Take the Sun Safety Quiz!

Exposure to the sun's ultraviolet (UV) rays appears to be the most important environmental factor involved in the development of skin cancer. Up to 80% of a person's lifetime exposure to the sunlight occurs during childhood and adolescence. It is very important to protect your children from the harmful rays of the sun. Although both tanning and burning can increase a person's risk of skin cancer, most Americans do not consistently protect themselves from UV rays. In Chester County, 38% of adult residents had a sun burn in the past year, and 79% stated they do not always use sunscreen or sun block. (PA BRFSS 07)
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Warning! Not all sunscreens offer complete protection. Look out for "sweatproof" or "waterproof" labeling on sunscreens, and make sure that the bottle claims to be "Broad spectrum" for the most protection from both UVA and UVB rays. Read the article "FDA Sheds Light on Sunscreens" for more information.

To prevent sun damage to your skin, practice these sun-safe behaviors:

  • Avoid the mid-day sun (10am-4pm). This is when the sun is at its strongest.
  • Use sun block with sun protection factor (SPF) 15 or higher.Apply a golf-ball sized amount with each application and reapply often. Remember to check the expiration date on the bottle.The Sun Protection Factor (SPF) describes how long a product will protect your skin when applied correctly. Fair-skinned people begin to burn in about 15 minutes on a sunny day, so wearing an SPF 15 sunscreen (if applied and reapplied properly) would prevent sunburn for about 225 minutes (15 SPF x 15 minutes until sun burn= 225).
  • Wear a wide-brimmed hat and sunglasses and stay in the shade whenever possible.
  • Wear protective, tightly woven clothing, such as a long-sleeved shirt and pants.
  • Avoid reflective surfaces, which can reflect up to 85% of the sun's damaging rays.
  • Avoid sunlamps and tanning beds.Artificial indoor tanning is thought to be linked to the increase in skin cancer cases at younger ages.
  • Protect children since severe burns in childhood can be a risk factor for developing cancer later in life. Visit EPA's Sunwise Program for a fun, interactive way for children to learn about the dangers of UV exposure.
Treatment varies based on the type, stage and location of the skin cancer, the patient's medical history and personal preferences Sometimes, all of the cancer is removed during a biopsy and no further treatment is needed. Further treatments may include:
  • Surgery – Surgery is the most common treatment and it may be used to both diagnose and remove the skin cancer.
  • Photodynamic Therapy – A drug is applied topically and a certain kind of light source is applied which in combination kill the cancer cells.
  • Topical Chemotherapy – Medication in a cream or lotion form is applied directly to the skin for several weeks. This is used when the area of skin cancer has grown too large for surgical removal.
  • Chemotherapy – Medication to kill cancer cells that have spread are taken orally or by injection into the bloodstream.
Programs
The Health Department offers the following programs relating to skin cancer prevention:
  • Sun Safety for Children - This program is great for day care centers, pre-schools and youth groups. Sun safety protocols are available for childcare directors
  • Skin Cancer Prevention- Educational presentation outlining the types of skin cancers, risk factors and prevention. Can be tailored to K-12 audiences, adults and outdoor workers.
*Non-epithelial skin cancers, which are not reflected below, represent 7% of skin cancers that are tracked by central cancer registries. These statistics also do not include data for basal cell and squamous cell carcinomas, which are not tracked by central cancer registries.Incidence counts cover approximately 90% of the U.S. population; death counts cover approximately 100% of the U.S. population. Use caution when comparing incidence and death counts.

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