Significant Knowledge Gaps About Melanoma Skin Cancer

The Centers for Disease Control and Prevention (CDC) reported today that Americans have a low awareness of the hazards of melanoma skin cancer, even as incidence of the disease is increasing rapidly. CDC joined with the American Academy of Dermatology in releasing the results of a survey on melanoma awareness, as the two organizations co-sponsor a conference in New York aimed at prevention of the disease.

In the recent national survey of adults 18 years old and older, conducted by the American Academy of Dermatology (AAD) and published today in the CDC's Morbidity and Mortality Weekly Report (MMWR) to the nation, approximately 50 percent of the men and 35 percent of the women did not recognize the term melanoma. The youngest adults in the survey (aged 18-24 years) had the lowest indicators of melanoma awareness when asked about melanoma skin cancer risk factors, early warning signs, and the most likely sites on the body for melanoma to occur. Overall, only 26 percent of participants could correctly identify early signs of melanoma, and only 58 percent knew that a severe childhood sunburn is an established risk factor for the development of melanoma later in life.

These findings are especially troubling in light of the CDC's recent report that noted a 34 percent increase in melanoma mortality from 1973 to 1992 --- the third highest increase of all cancers and a 48 percent increase in mortality rates among men --- the highest increase in mortality for all cancers. Stephen W. Wyatt, DMD, MPH, of the CDC acknowledges, "The disease burden associated with skin cancer is indeed staggering and demands our attention."

The awareness gap among young adults is of special concern because a severe sunburn at an early age has a strong association with the development of melanoma later in life. Some studies have shown that the majority of lifetime sun exposure occurs before the age of 18 years. These findings emphasize the importance of educating young people, their parents, and others about healthy sun behaviors. "This is a real opportunity for prevention and further underscores the value of education," stated David Satcher, CDC's Director. The CDC, in collaboration with the AAD, has initiated the National Skin Cancer Prevention Education Program to increase public awareness about skin cancer and help the nation achieve skin cancer prevention objectives established by Healthy People 2000.

The AAD conducted the telephone survey of a nationwide probability sample of 1,001 adults 18 years old and older; almost equal numbers of men and women responded to the survey. The sample consisted of respondents from 43 states; of these, 36 percent resided in the southern United States.

Risk factors for melanoma include a history of severe sunburn occurring early in life, light color skin, a family history of melanoma, a personal history of melanoma, and the presence of moles and freckles. Recommendations for preventing the development of melanoma should emphasize healthy sun behaviors for all Americans. Healthy sun behaviors include reducing direct exposure to the sun, especially from 10 a.m. to 4 p.m.; wearing a broad-brimmed hat and clothes that protect sun-exposed areas of the body; using a sunscreen with a sun protection factor (SPF) equal to or greater than 15 as a protection against ultraviolet A and B radiation; and referring to the daily Ultraviolet Index (UV Index - - available in 58 cities) rating when planning outdoor activities.

The Partners in Prevention Conference, a joint initiative of the AAD and the CDC, convened this week in New York City, to explore effective mechanisms for developing partnerships with members of the media and the advertising industry, executives from the private sector, health care professionals from the medical community, members of the sports and recreation industry, leaders of unions, and health professionals and policymakers from government agencies. One of the objectives of the conference was to provide direction for the development and delivery of media messages aimed at children, parents with young children, and adults, and to produce recommendations that provide direction to the National Skin Cancer Prevention Education Program. The conference is the second in a series of three to address the public health burden of skin cancer. A report of the 1995 agenda-setting conference will be available in May 1996.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES