Office of Air and Radiation (6205J)   EPA-430-F-09-064   May 2009
survivor story:

Shonda Schilling

              In summer 1999, my family
              noticed a mole on my back
              that "didn't look right." I put
              off getting it checked—partly
              because I didn't see it as
              a priority, and I enjoyed
tanning. I finally saw a dermatologist in 2001.
Just 36 hours after my appointment, I received
a phone call that changed my life: I had Stage 2
malignant melanoma.

I knew something might be wrong since the
mole would often burn or itch, but the news I
had cancer was a shock. The doctors needed
to see if it had spread. The result: I had a 6-inch
section of my back removed immediately and
had five more surgeries overthe nextyearto
remove two more Stage 2 melanomas and four
in situ melanomas from my back, chest, legs,
and arms. My scars are a constant reminder of
the need to be SunWise.

Take it from me: If you spend time in the sun,
checkyour skin for changes regularly or have
your family help. If something doesn't look
right—tell your doctor immediately!

After her diagnosis of melanoma, Shonda Schilling
established the SHADE Foundation of America in 2002 to
educate the public about skin cancer.
Skin cancer is the most common  cancer diagnosed
in the United States.1"4 This fact sheet presents
statistics about skin cancer for Massachusetts and the
United States as a whole.


small  state: Big Problem
• Sunburns on the Rise. A 2004 survey found that 43% of white adults
   in Massachusetts had at least one sunburn in the past year—an
   increase from 35% in 1999.5 Sunburns are a significant risk factor for
   the development of skin cancer.6'8

• New Cases of Melanoma. The rate of new melanoma diagnoses—
   responsible for 75% of all skin cancer deaths—was 26% higher in
   Massachusetts than the national average and was the 9th highest in
   the U.S. from 2001-2005.9'10 An estimated 2,000 state residents were
   diagnosed with melanoma  in 2008.2

   •   Nantucket County has one of the top 5 rates of new melanoma
      diagnoses among counties nationwide, 146% above the
      national average.11

• Deaths from Melanoma. More than 250 people in Massachusetts die of
   melanoma every year.9 Massachusetts had the 15th highest melanoma
   death rate  nationally from 2001-2005—7% higher than the U.S. average.12

   •   Hampshire County has the highest melanoma  death rate in the
      state, 63% higher than the national average.9
                                               40 All references can be found on the SunWise Web site at: www.epa.gov/sunwise/statefacts.html
Melanoma Death Rates, 2001-20059
All Races, Both Sexes, All Ages
              Annual Rate of New Melanoma Diagnoses, 2001-20059
              All Races, Both Sexes, All Ages
  Melanoma Deaths per Year per 100,000 People
                                                             Melanoma Diagnoses per Year per 100,000 People

                                                               15.4-22.2 Q22.3-29.2 1^29.3-36.1 Q36.2-43.0

                                                               Suppressed Data
     Recycled/Recyclable—Printed with vegetable oil-based inks on paper that contains at least 50% post-consumer fiber.

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     The  Cost of Skin Cancer
            In  the U.S., medical costs to  treat
            skin cancer are estimated at almost
            $2 billion annually.13'14
statistics:  Cause for  Concern

• In 2008, more than 1 million people were diagnosed
   with skin cancer, making it the most common of all
   cancers.1"4 More people were diagnosed with skin
   cancer in 2008 than with breast, prostate, lung, and
   colon cancer combined.2 About 1 in 5 Americans
   will develop skin cancer during their lifetime.16

• One American dies of melanoma almost every hour.2

• Melanoma is the second most common form of
   cancer for adolescents and young adults (15-29
   years old).17

• For people born in 2005,1 in 55 will be diagnosed
   with melanoma12— nearly 30 times the rate for
   people born in 1930.18
            National Annual Rate of New Melanoma Diagnoses, 2001-2005"
            All Races, Both Sexes, All Ages, Age-adjusted Rates
             Melanoma Diagnoses per Year per 100,000 Peopl
            * Please note that delays in reporting melanoma cases to cancer registries are more common since they are usually
             diagnosed and treated in non-hospital settings such as physician offices. States are grouped into quintiles based
             on rates of melanoma diagnoses. A quintile is a statistical "block" representing 20% of a total. Because data
             are available for only 45 states and D.C., four quintiles include nine states, and one includes 10. For example,
             the ten states with the highest melanoma rates—21.8 to 28.6 diagnoses per 100,000 residents every year—are
             in the top quintile.
what works:

An  Ounce of Prevention

• Unprotected exposure to ultraviolet light is the most preventable
   risk factor for skin cancer.6'16'19'22 Taking simple steps as early in life
   as  possible can reduce one's risk.2A23~24

• Early detection of melanoma can save one's life.25 31 Skin
   examinations may be the best way to detect skin cancer early.2'32'36

• The CDC found evidence that education and policy approaches
   in primary schools (for children) and in recreational or tourism
   settings (for adults) can improve sun safety behaviors.37 38

• Student self-reported  data39—collected as part of the U.S. EPA's
   SunWise Program—showed that teachers using the SunWise Tool
   Kit for 1-2 hours yearly can spur increases in students' sun safety
   knowledge and attitudes and  small to modest improvements in
   short-term sun safety  behaviors.40

   •  Using the data mentioned above, published modeling results
      show SunWise teaching between 1999 and 2015 could prevent
      more than 50 premature deaths and 11,000 future cases of skin
      cancer, saving the  country more than $30 million in medical costs
      and productivity losses.40

1~40 All references can be found on the SunWise Web site at: www.epa.gov/sunwise/statefacts.html
                               skin cancer prevention:

                               Action Steps

                               • Do Not Burn. Overexposure to the sun is the
                                 most preventable risk factor for skin cancer.

                               • Avoid Sun Tanning and Tanning Beds.
                                 UV light from tanning beds and the sun
                                 causes skin cancer and wrinkling.

                               • Use Sunscreen. Generously apply a broad
                                 spectrum sunscreen with an SPF of 15 or
                                 higher. Reapply at least every two hours, and
                                 after swimming or sweating.

                               • Cover Up. Wear protective clothing, such as
                                 a long-sleeved shirt, pants, a wide-brimmed
                                 hat, and sunglasses with 99-100% UVA/UVB
                                 protection, when possible.

                               • Seek Shade. Seek shade when the sun's
                                 UV rays are most intense between 10 a.m.
                                 and 4  p.m.

                               • Watch for the UV Index. Pay attention to the
                                 UV Index when planning outdoor activities to
                                 prevent overexposure to the sun.
     www.cdc.gov/cancer/skin
www.epa.gov/sunwise

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