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A presentation about the increased incidence of melanoma among the younger population in the United States and what can be done about it.
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LOVE T
HE SKIN
YOU’R
E IN
CH
AN
GI N
G T
HE
OU
TL
OO
K
OF
ME
LA
NO
MA
I NC
I DE
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E
Kimberly Simons, PA-S3
University of Toledo
MATT KOHMESCHER
On July 14, 2014 he celebrated his 30th Birthday
Diagnosed with Stage IV Melanoma weeks later
Passed away January 30, 2015
His fight continues by increasing awareness about this preventable killer…
RESEARCH QUESTIONS
• What variables are important influences on UV exposure behaviors in order to decrease the incidence of melanoma?
• In order for there to be a significant impact on decreasing the incidence of melanoma, what is the best approach?• What role can Physician Assistants play in that approach?
METHODS
Database: PubMed
Search Terms:• melanoma, skin cancer, suntan, tanning, indoor tanning, UV radiation,
sun protection, sunscreen, sunless tanner, sunless tanning, melanoma epidemiology, melanoma incidence, perceived risk, and perceived norm
Inclusion Criteria:• Written after 2000• Research within the United States
Initial Search: 42 articles
Additional: 38 sources• Internet resources for data and further research:• cdc.gov, fda.gov, ftc.gov, healthypeople.gov, aad.org, and
cancer.org
INTRODUCTION• Lifetime risk of diagnosis has increased• 1 in 39 risk in 2010
• Most common cancer in people aged 25-29 years
• Healthy People 2020 Objectives
• World Health Organization: UV radiation is carcinogenic• No deterrence to indoor tanning
BACKGROUNDRisk Factors:
Non-Modifiable Modifiable
Skin Type Socioeconomic Status
Genetics Ultraviolet Radiation
Age
Gender
UV PROTECTION
• Sun protective behavior is low in the U.S.
• Noticeable downward trend in sunscreen use in the U.S. among high school students between 1999-2009
• Chronic vs. Intermittent UV Exposure – Melanoma site• Pattern of sunscreen use
• Physical vs. chemical broad-spectrum sunscreens
• Cost and availability of sunscreens
SUNLESS TANNING
• No UV exposure to achieve tanned skin
• Dihydroxyacetone (DHA): active ingredient in most sunless tanning products• Nontoxic and hypoallergenic
• False sense of UV protection?
• Negative correlation between sunless tanning use and UV exposure
INDOOR TANNING
• Indoor tanning devices: Class II carcinogen• Black box warning requirement for users < 18 years-old• Indoor tanning devices and promotional material must include
warning
• Rates of indoor tanning higher in younger age groups
• Popularity linked to access
STATE AND FEDERAL REGULATIONS
• No federal regulations regarding minors’ use of indoor tanning facilities
• Lack of enforcement of regulations
• Evidence supports that increasing and enforcing minimum age laws for substances such as alcohol is effective• These laws may have similar effects on indoor tanning
• Parental consent for minors not adequate
COMMUNITY PROGRAMS
PA = POWER
ROLE MODELS
CONCLUSION
• Stricter regulations that are properly enforced
• Patient education: children and parents
• Communities, schools and workplaces – prevention programs• Increased shade at playgrounds, public pools and other public
spaces• Promoting sun protection in recreation areas including the use or
purchase of sunscreen, hats and sunglasses• Employee and student education about sun protection• Employee and student access to protective clothing and sunscreen• Scheduling outdoor activities around midday hours
QUESTIONS
