Dramatic increase in melanoma incidence among American Youth.
Melanoma has become a major health problem in our society because of our obsession with the "perfect tan". Melanoma was once considered a cancer of adults because it was rarely diagnosed in young people. However, reports that melanoma had increased in children and young adults by 3% a year between 1973 and 2001 made it difficult to ignore this alarming trend (Strouse, 2005). Skin cancer may be missed in young patients because the health care provider does not appreciate that young patients are at risk for developing the disease. This lack of understanding or low index of suspicion may prove deadly for some patients.
There will be an estimated 62,190 new cases of melanoma diagnosed in the United States in 2006. Many of those diagnosed with the disease will be children and young adults. Melanoma is the most common cancer diagnosed in white females ages 20-24 and the fourth most common in young males of the same age (www.seer.cancer.gov/csr/1975_2001).
* US National Cancer Institute
With one American dying every hour from skin cancer we must have a better understanding of skin cancer prevention and early detection.
Ultraviolet light was added to the list of proven human carcinogens in 2002. The NIH reported that exposure to ultraviolet light from either sunlight or artificial tanning sources were associated with skin cancer, cancer of the lip and melanoma of the eye. (10th Report on Carcinogens, 2002). Childhood sun exposure is a very important risk factor for melanoma. Half of all American children report having one summer sunburn and 12% of adolescents experience at least 5 sunburns (Davis, 2002). In addition, the popularity of indoor tanning is increasing among teenagers with rates of indoor tanning doubling between 14-15 and 15-16 years of age (Geller, 2002). Preventing sunburns is very important because it is a major risk factor for developing melanoma (Tsao et al., 2004).
Melanocytes are pigment producing cells that are genetically programmed to determine skin and eye color. Moles are harmless growths that arise from melanocytes. The tendency to develop moles is inherited however sun exposure may increase the number of moles we acquire or develop during our lifetime (American Academy of Dermatology, 2006). Because half of all melanomas develop in moles it is important to limit the number of acquired moles. Sunburn prevention is important because it may protect children from acquiring new moles and therefore reduce melanoma risk.
Melanomas are usually pigmented and may include brown, black, blue, or grey pigments. Although, some melanomas lack pigment and appear red or pink. Melanomas in young children may appear as a red bump or pink papule on the skin (amelanotic). The classic warning signs of melanoma include Asymmetry, Border irregularity, Color variability, enlarging Diameter or an Evolving growth. However, we recommend that any new or changing growth persisting for more than one month be evaluated by a health care provider.
Anyone can develop melanoma, although the risk is greatest for individuals with light eyes, pale skin, freckles, excessive sun exposure in childhood, a large number of common or atypical moles and a family history of melanoma. Female gender has become a major risk factor for developing melanoma in young white Americans. Melanoma is twice as common in young white females aged 20-24 as compared to males of the same age and ethnicity (Strouse, 2005).
Children's Melanoma Prevention Foundation was formed to combat the dramatic increase in melanoma among American youth. We have partnered with schools to educate, motivate and reduce skin cancer in our society. Our SunAWARE Program is multilayered and provides skin cancer prevention lessons to students, parents, nurses and teachers. Our skin cancer workshops are designed to educate nurses about skin cancer prevention and early detection. We provide students with a rationale for sun protection. We encourage students to identify the factors that effect UV intensity and skin sensitivity. We teach practical lessons on sun protection along with tips for early detection of skin cancer. We encourage children to have fun in the outdoors but to take appropriate precautions to protect their health.
Maryellen Maguire-Eisen RN, MSN
Executive Director