Transcript for CDC Telebriefing: New Vital Signs Report – What role do communities have in skin cancer prevention efforts?

AMY ROWLAND: Thank you Shirley and thank you all for joining us today for the release of a new CDC “Vital Signs,” this one on how communities can prevent skin cancer cases. We’re joined today by the Director of CDC’s National Center for Chronic Disease Prevention and Health Promotion, Dr. Ursula Bauer and by Dr. Lisa Richardson, Director for the Division of Cancer Prevention and Control. At this time I will turn the call over to Dr. Bauer.

URSULA BAUER: Thank you Amy and thank you all for joining us today to discuss CDC’s Vital Signs report. This is a special MMWR publication that highlights important public health issues. Each month in Vital Signs, CDC focuses on the latest data about one of many critical health issues facing our nation – and, more specifically, what can be done about it. CDC works 24/7 to keep Americans healthy, safe and secure.

Today, we’re talking about a health threat that many Americans may not think about – skin cancer. While rates of many other cancers are decreasing, melanoma skin cancer rates are growing in the United States. Melanoma is the deadliest form of skin cancer, causing 9,000 deaths in this country every year. It is also one of the most common types of cancer among U.S. adolescents and young adults. The incidence of melanoma is increasing – even as other cancer rates are coming down. The incidence has doubled in the past 30 years. And as the incidence goes up, so does the costs. In fact, we project that by 2030 – if we do nothing, the number of melanoma cases will continue to increase to 112,000 and costs to treat melanoma will triple to $1.6 billion a year.

Last month was Melanoma Awareness Month and CDC released an article on Americans low-use of sunscreen and what we can all do to better protect ourselves from the sun. Now, this Vital Signs report addresses the actions communities and policymakers can take to improve sun protection. What are these skin cancer prevention actions? According to the Guide to Community Preventive Services, successful community efforts combine education, mass media campaigns, and policy changes to increase skin protection for children and adults. We’ll describe these in more detail in a moment. First, here’s what we know and what we can do about it. People can reduce their risk for melanoma by avoiding indoor tanning and by wearing sun protection like wide-brimmed hats, protective clothing, sunglasses, and a broad-spectrum sunscreen with a Sun Protection Factor, or SPF, of 15 or more while outside. But these actions are not enough. We need community-wide efforts, such that agencies and organizations, schools, colleges, universities, businesses and employers, healthcare systems, insurers, and clinicians all take an active role in preventing melanoma by promoting skin safe behaviors.

For example, this summer, my family and I will enjoy the outdoors, whether tubing on the Chattahoochee River, picnicking in a state park, or strolling through town. We’ll do these activities wearing sunscreen and protective clothing and making use of shade structures. In addition, in my example, the tubing company can offer sunscreen and wide-brimmed hats, and parks and public places can provide shade structures. And businesses and events can offer reminders to protect our skin while we’re active outside. Establishing community norms around skin protection and making it second nature helps ensure that everyone can safely enjoy the outdoors and all it has to offer to keep us healthy.

AMY ROWLAND: Thank you Dr. Bauer, we will now hear from Dr. Lisa Richardson, who is a Medical Oncologist and Director for the Division of Cancer Prevention and Control.

LISA RICHARDSON: Thank you Amy and thank you Dr. Bauer. Ultraviolet, or UV, exposure is a major cause of melanoma, and it is also the most preventable cause. Sources of exposure to UV radiation include the sun and artificial sources like indoor tanning beds. Tans and sunburns are the skin’s natural response to damage. More than 1 in 3 Americans report being sunburned at least once every year. When people tan or sunburn, it increases their chances of getting melanoma. Genetic factors like being fair-skinned or having a family history of skin cancer can contribute to risk. UV radiation causes more than 90 percent of melanoma skin cancers in the U.S. Everyone has a risk of developing melanoma regardless of racial and ethnic background. It is all about your natural skin tone; the lighter you are, the higher your risk. For this reason, I encourage everyone to protect themselves from UV exposure. Indoor tanning exposes people to even more intense UV rays than the sun. It’s estimated that about 6,200 melanomas are caused each year in the U.S. by indoor tanning.

Patterns in new cases of and deaths from melanoma vary according to age group. Other research has shown there may be different reasons for these patterns. For people younger than 65, there have been increases in melanoma incidence, but decreases in death. This is most likely related to earlier detection and improved treatment. Cancers that are detected earlier are generally easier to treat. For people 65 and older, both rates of new cases and deaths are increasing. In this age group, increases in new cases and deaths are occurring for both early- and late-stage melanomas. This is likely related to overexposure to UV radiation over a lifetime. The annual cost for treating melanoma has increased faster than the annual cost for all other cancers combined.

Without community intervention, the cost of treating new melanoma patients is projected to triple through the year 2030. What can get lost in these big numbers are the people affected by melanoma. As an oncologist, I’ve had to give the bad news that they have melanoma. Unfortunately, more and more providers are having to break this news to patients–178 every day, which is 65,000 diagnoses a year. This is devastating news to patients and their families. We know that melanoma is preventable, and that communities play a vital role in prevention efforts. More communities supporting skin cancer prevention means fewer people will have to deal with a melanoma diagnosis in the future. According to this Vital Signs report, effective community skin cancer prevention programs could prevent an estimated 230,000 melanoma cancers and save $2.7 billion dollars in treatment costs between 2020 and 2030.

So what can we do reduce the incidence of melanoma skin cancer in this country? Communities and policymakers can get involved by collaborating with schools, employers, and community organizations to take action. Schools can increase shade structures in playgrounds and promote sun protection education. Communities can also encourage school districts to promote sun protection in their wellness policies. Schools and early learning centers can reschedule or relocate activities to provide or plan for shade. They can also revisit policies that ban students from wearing hats or using sunscreen. Communities can work with parks and recreation departments to increase shade in public spaces such as public pools and parks, and promote sun protection in these areas by encouraging the use or purchase of sunglasses, sunscreen, and hats. Communities can also encourage employers, child care centers, schools, and colleges to educate about sun safety.

Businesses whose employees work outside can structure the work day to avoid times when the sun is strongest during midday hours, when possible. They can increase the amount of shade available to workers, using tents, shelters, and cooling stations. Sun safety training can also be added to workplace policies. We know that nearly 1 in 3 non-Hispanic white women ages 16 to 25 uses indoor tanning each year. High schools can encourage student-led campaigns before big events like the prom or spring break to raise awareness about the risks of sunbathing or indoor tanning. Colleges and universities can strengthen campus policies to reduce indoor tanning as well. Some states have provisions in place already restricting indoor tanning for minors; other states can consider similar policies. Protecting minors from indoor tanning is no different than protecting them from other known causes of cancer like cigarettes.

The Federal Government has measures in place to support sun safety and skin cancer prevention. More Americans have healthcare coverage through the Affordable Care Act, including preventive services. Behavioral counseling is now provided with no cost-sharing to counsel young people ages 10-24 with fair skin about the dangers of UV rays and how to prevent skin cancer. Healthcare providers can also counsel patients to use sun protection and to avoid indoor tanning. They can encourage behaviors that will protect skin from harmful UV exposure. Communities and policymakers can support individual efforts with sun protection actions for public places and spaces, especially through employers, childcare centers, school and colleges, and recreation areas. Let’s see everyone outside having fun—with sunscreen, hats, and other protective clothing.

The bottom line is this: Melanoma is a cancer we know how to prevent, but it is still killing many people nationwide. We can all do our part to protect Americans from this largely preventable cancer. What we do know is that tanned skin is damaged skin and we all need to do what we can to protect ourselves and others.

AMY ROWLAND: Thank you Dr. Bauer and Dr. Richardson. Shirley, we’re ready for questions now.

OPERATOR: Thank you. At this time we are ready to begin the question and answer session. If you would like to ask a question, please press Star 1. You will be prompted to record your name. To withdraw your question, you may press Star 2. Again, press Star 1 to ask a question and one moment please for our first question. At this time I’m showing no questions. Again please press Star 1 if you would like to ask a question. One moment please. At this time I’m showing no questions.

AMY ROWLAND: Thank you Shirley. Thank you Dr. Bauer and Dr. Richardson and reporters for joining today’s telebriefing on rates of new Melanoma. For follow up questions, please call CDC’s press office at 404-639-3286 or send an email to media@cdc.gov. A transcript of today’s telebriefing will be available later this afternoon. To access the transcript, visit cdc.gov/media and for more information about the report please visit the cdc.gov/vitalsigns. Thank you again for joining us. This concludes our call.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES