Approximately one million Americans are diagnosed with skin cancer each year. Since melanoma and skin cancer are amenable to prevention, education, and early detection, efforts to reduce the incidence of and death from melanoma have developed in many countries. Programs promoting behavioral changes and the incorporation of skin cancer control into national health care agendas have begun in a number of countries. Additional programs for the at-risk and general populations require further development and evaluation.
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References
1.
KohH.K.Cutaneous melanoma. N Engl J Med.1991; 325: 171–182.
2.
MillerD.L., WeinstockM.A.Nonmelanoma skin cancer in the United States: incidence. J Am Acad Dermatol.1994; 30: 774–778.
3.
Cancer Facts & Figures - 1995.Atlanta, Ga: American Cancer Society; 1995.
4.
MillerB.A., RiesL.A., HankeyB.F.Cancer statistics review 1973–1989.National Cancer Institute. National Institutes of Health publication 92–2789. 1992.
5.
Deaths from melanoma - United States, 1973–1992. MMWR Morb Mortal Wkly Rep.1995 May 5;44: 337, 343–347.
6.
ArmstrongB.K., KrickerA.How much melanoma is caused by sun exposure?Melanoma Res.1993; 3: 395–401.
7.
MarksR., HillD.The Public Health Approach to Melanoma Control: Prevention and Early Detection.Geneva, Switzerland: International Union Against Cancer; 1992.
8.
KohH.K., GellerA.C., MillerD.R.The early detection of and screening for melanoma. Cancer.1995; 75(Suppl 2): 674–683.
9.
RhodesA.R.Public education and cancer of the skin: what do people need to know about melanoma and nonmelanoma skin cancer?Cancer.1995; 75(Suppl 2): 613–636.
10.
American Academy of Dermatology and Centers for Disease Control and Prevention.National conference to develop a skin cancer agenda. Cancer.1995. Submitted.
11.
MeliaJ., EllmanR., ChamberlainJ.Meeting the Health of the Nation target for skin cancer: problems with tackling prevention and monitoring trends. J Public Health Med.1994; 16: 225–232.
12.
Health Canada and Environmental Canada. Public education messages for reducing health risks from UV radiation. Quebec, Canada. September 24–25, 1994.
13.
BoldemanC., UllenH.Mansson-Brahme E, et al. Primary prevention of malignant melanoma in the Stockholm Cancer Prevention Programme. Eur J Cancer Prev.1993; 2: 441–446.
14.
LewR.A., KohH.K., SoberA.J.Epidemiology of cutaneous melanoma. Dermatol Clin.1985; 3: 257–269.
15.
RhodesA.R., WeinstockM.A., FitzpatrickT.B.Risk factors for cutaneous melanoma: a practical method of recognizing predisposed individuals. JAMA.1987; 258: 3146–3154.
16.
MarksR.Melanoma prevention: is it possible to change a population's behavior in the sun?Pigment Cell Res.1994; 7: 104–106.
17.
HillD., WhiteV., MarksR.Changes in sun-related attitudes and behaviours, and reduced sunburn prevalence in a population at high risk of melanoma. Eur J Cancer Prev.1993; 2: 447–456.
18.
RossiJ.S., BlaisL.M., ReddingC.A.Preventing skin cancer through behavior change: implications for interventions. In: WeinstockM., ed. Dermatologic Clinics.Philadelphia, Pa: WB Saunders; 1995.
19.
KohH.K., LewR.A.Sunscreens and melanoma: implications for prevention. J Natl Cancer Inst.1994; 86: 78–79.
20.
BologniaJ.L., BerwickM., FineJ.A.Sun protection in newborns: a comparison of educational methods. Am J Dis Child.1991; 145: 1125–1129.
21.
BullerM.K., LoescherL.J., BullerD.B.“Sunshine and skin health”: a curriculum for skin cancer prevention education. J Cancer Educ.1994; 9: 155–162.
22.
MermelsteinR.J., RiesenbergL.A.Changing knowledge and attitudes about skin cancer risk factors in adolescents. Health Psychol.1992; 11: 371–376.
23.
KatzR.C., JerniganS.Brief report: an empirically derived educational program for detecting and preventing skin cancer. J Behav Med.1991; 14: 421–428.
24.
RossiJ.S., BlaisL.M., WeinstockM.A.The Rhode Island Sun Smart Project: skin cancer prevention reaches the beaches. Am J Public Health.1994; 84: 672–674.
25.
LombardD., NeubauerT.E., CanfieldD.Behavioral community intervention to reduce the risk of skin cancer. J Appl Behav Anal.1991; 24: 677–686.
26.
HollowayL.Atmospheric sun protection factor on clear days: its observed dependence on solar zenith angle and its relevance to the shadow rule for sun protection. Photochem Photobiol.1992; 56: 229–234.
27.
KohH.K., KliglerB., LewR.A.Sunlight and cutaneous malignant melanoma: evidence for and against causation. Photochem Photobiol.1990; 51: 765–779.
28.
KerrJ.B., McElroyC.T.Evidence for large upward trends of ultraviolet-B radiation linked to ozone depletion. Science.1993; 262: 1032–1034.
29.
FrederickJ.E., SoulenP.R., DiazS.B.Solar ultraviolet irradiance observed from southern Argentina: September 1990 to March 1991. J Geophys Res.1993; 98: 8891–8897.
30.
BerwickM., FineJ.A., BologniaJ.L.Sun exposure and sunscreen use following a community skin cancer screening. Prev Med.1992; 21: 302–310.
31.
CockburnJ., HennrikusD., ScottR.Adolescent use of sun- protection measures. Med J Aust.1989; 151: 136–140.
32.
JohnsonE.Y., LookingbillD.P.Sunscreen use and sun exposure: trends in a white population. Arch Dermatol.1984; 120: 727–731.
33.
BanksB.A., SilvermanR.A., SchwartzR.H.Attitudes of teenagers toward sun exposure and sunscreen use. Pediatrics.1992; 89: 40–42.
34.
KohH.K., BakS.M., GellerA.C.Sunbathing habits and sunscreen use in 2459 Caucasian adults: results of a national survey. American Public Health Association Meeting, October, 1992. Submitted Am J Public Health, 1995.
35.
GellerA.C., KohH.K., MillerD.R.Death rates of malignant melanoma among white men - United States, 1973–1988. MMWR Morb Mortal Wkly Rep.1992; 41: 20–22, 27.
36.
WagenerD.K.Patterns of melanoma deaths in the United States. In: DavisD.L., HoelD., eds. Trends in Cancer Mortality in Industrial Countries.New York, NY: NY Academy of Sciences: 1990; 609; 252–258.
37.
CookeK.R., McNoeB.M.Targeting early detection of malignant melanoma of the skin. N Z Med J.1990; 103: 551–553.
38.
McHenryP.M., HoleD.J., MacKieR.M.Melanoma in people aged 65 and over in Scotland, 1979–89. Br Med J.1992; 304: 746–749.
39.
DavisN.Modern concepts of melanoma and its management. Ann Plast Surg.1978; 1: 628–629.
40.
MacKieR.M., DohertyV.R.Seven-point checklist for melanoma. Clin Exp Dermatol.1991; 16: 151–153.
41.
Summary and analysis of the American Academy of Dermatology National Skin Cancer Screening Database with recommendations for public and professional awareness and education. Division of Cancer prevention and Disease Control, Centers for Disease Control and Prevention, 1994.
42.
KohH.K., CarusoA., GageI.Evaluation of melanoma/skin cancer screening in Massachusetts: preliminary results. Cancer.1990; 65: 375–379.
43.
National Program for the Prevention and Early Detection of Melanoma and Other Skin Cancers. American Academy of Dermatology and Centers for Disease Control and Prevention, Schaumburg, Ill.
44.
MillerD.R., KohH.K., GellerA.C.National survey of skin cancer awareness. American Public Health Association, San Francisco, Calif, 1993. Am J Public Health.1995. Submitted.
45.
CampbellS., BirdsellJ.M.Knowledge, beliefs, and sun protection behaviors of Alberta adults. Prev Med.1994; 23: 160–166.
46.
BorlandR., MarksR., NoyS.Public knowledge about characteristics of moles and melanomas. Aust J Public Health.1992; 16: 370–375.
47.
CockerellC.J., HowellJ.B., BalchC.M.Think melanoma. South Med J.1993; 86: 1325–1333.
48.
BrodkinR.H., AltmanE.M.Controlling malignant melanoma: a focus on pediatricians. Am J Dis Child.1993; 147: 875–881.
49.
SackettD.L., HollandW.W.Controversy in the detection of disease. Lancet.1975; 2: 357–359.
50.
KohH.K., MillerD.R., GellerA.C.Who discovers melanoma: patterns from a population-based survey. J Am Acad Dermatol.1992; 26: 914–919.
51.
ElwoodJ.M., GallagherR.P.The first signs and symptoms of melanoma: a population-based study. In: ElwoodJ.M., ed. Melanoma and Naevi: Incidence, Interrelationships, and Implications.Basel, Switzerland: Karger; 1988: 140–152.
52.
GreenA.Incidence and reporting of cutaneous melanoma in Queensland. Aust J Dermatol.1982; 23: 105–109.
53.
GellerA.C., KohH.K., MillerD.R.Use of health services before the diagnosis of melanoma: implications for early detection and screening. J Gen Intern Med.1992; 7: 154–158.
54.
DohertyV.R., MacKieR.M.Experience of a public education programme on early detection of cutaneous malignant melanoma. Br Med J.1988; 297: 388–391.
55.
ElwoodJ.M.Screening for melanoma and options for its evaluation. J Med Screen.1994; 1: 22–38.
56.
MacKieR.M., HoleD.Audit of public education campaign to encourage earlier detection of malignant melanoma. Br Med J.1992; 304: 1012–1015.
57.
FriedmanR.J., RigelD.S., SilvermanM.K.Malignant melanoma in the 1990s: the continued importance of early detection and the role of physician examination and self-examination of the skin. CA Cancer J Clin.1991; 41: 201–226.
58.
KohH.K., GellerA.C.Melanoma detection: emphasis on older men. Prim Care Cancer.1993; 5: 18–24.
59.
BalchC.M., SoongS.J., ShawH.M.An analysis of prognostic factors in 8500 patients with cutaneous melanoma. In: BalchC.M., HoughtonA.N., MiltonG.W., eds. Cutaneous Melanoma.2nd ed.Philadelphia, Pa: JB Lippincott Co; 1992.
60.
Maguire-EisenM., FrostC.Knowledge of malignant melanoma and how it relates to clinical practice among nurse practitioners and dermatology and oncology nurses. Cancer Nurs.1994; 17: 457–463.
61.
BologniaJ.L., BerwickM., FineJ.A.Complete follow-up and evaluation of a skin cancer screening in Connecticut. J Am Acad Dermatol.1990; 23: 1098–1106.
62.
KohH.K., MillerD.R., GellerA.C.Screening for melanoma/skin cancer in the United States. In: GallagherR.P., ed. Epidemiology of Malignant Melanoma.Berlin, Germany: Springer-Verlag; 1994.
63.
MorrisonA.S.Screening in Chronic Disease.New York, NY: Oxford University Press; 1985.
64.
KohH.K., GellerA.C., MillerD.R.Who is being screened for melanoma/skin cancer: characteristics of persons screened in Massachusetts. J Am Acad Dermatol.1991; 24: 271–277.
65.
WeinstockM.A.Prevalence of the early warning signs of melanoma among participants in the 1989 Rhode Island skin cancer screening. J Am Acad Dermatol.1990; 23: 516–518.
66.
McGeeR., ElwoodM., WilliamsS.Who comes to skin checks?N Z Med J.1994; 107: 58–60.
67.
KohH.K., GellerA.C., MillerD.R.Health care access issues in national skin cancer screening programs. Presented at the American Public Health Association meeting; November 1994; Washington, DC. Abstract 2132.
68.
KrickerA., EnglishD.R., RandellP.L.Skin cancer in Geraldton, Western Australia: a survey of incidence and prevalence. Med J Aust.1990; 152: 399–407.
69.
BrandbergY., BolundC., MichelsonH.Psychological reactions in public melanoma screening. Eur J Cancer.1993; 29A: 860–863.
70.
FreedbergK.A., GellerA.C., MillerD.R.Screening for malignant melanoma: a cost-effectiveness analysis. J Gen Intern Med.1995. Submitted.
71.
Healthy People 2000: National Health Promotion and Disease Prevention Objectives.Washington, DC: US Dept of Health and Human Services; Public Health Services publication (PHS) 91–50212. 1991.
72.
BerwickM., RoushG., ThompsonW.D.Evaluating the efficacy of skin self- exam and other surveillance measures in persons at various levels of risk for cutaneous melanoma: an ongoing case-control study. Prog Clin Biol Res.1989; 293: 297–305.
73.
MacKieR.M., McHenryP., HoleD.Accelerated detection with prospective surveillance for cutaneous malignant melanoma in high-risk groups. Lancet.1993; 341: 1618–1620.
74.
MasriG.D., ClarkW.H.Jr, GuerryDIV. Screening and surveillance of patients at high risk for malignant melanoma result in detection of earlier disease. J Am Acad Dermatol.1990; 22: 1042–1048.
75.
VasenH.F., BergmanW., van HaeringenA.The familial dysplastic nevus syndrome: natural history and the impact of screening on prognosis. A study of nine families in The Netherlands. Eur J Cancer Clin Oncol.1989; 25: 337–341.
76.
RoushG.C., McKayL., HolfordT.R.A reversal of the long-term increase in deaths attributable to malignant melanoma. Cancer.1992; 69: 1714–1720.
77.
DennisL.K., WhiteE., LeeJ.A.Recent cohort trends in malignant melanoma by anatomic site in the United States. Cancer Causes Control.1993; 4: 93–100.
78.
ThornM., SparenP., BergstromR.Trends in mortality rates from malignant melanoma in Sweden 1953–1987 and forecasts up to 2007. Br J Cancer.1992; 66: 563–567.
