Office of Air and Radiation (6205J)   EPA-430-F-09-065   May 2009
Skin cancer is the most common cancer diagnosed in the
United States.1"4 This fact sheet presents statistics about skin
cancer for New Hampshire and the United States as a whole.

small  state:  Big Problem
• Sunburns. A 2004 survey found that 43.8% of white adults in New Hampshire had
   at least one sunburn in the past year.5 Sunburns are a significant risk factor for the
   development of skin cancer.6'8

• New Cases of Melanoma. New Hampshire had the second highest rate of new
   melanoma diagnoses in the U.S. from 2001-2005,61% higher than the national
   average.9'10 In 2008, an estimated 400 state residents were diagnosed with
   melanoma, which is responsible for 75% of all skin cancer deaths.2

   •  Grafton County has the highest rate of melanoma diagnoses in the state,
      160% above the national average.9

• Deaths from Melanoma. More than 40 people in New Hampshire die of melanoma
   every year.11 New Hampshire had the 7th highest melanoma death rate  nationally
   from 2001-2005—18.5%  higherthanthe U.S. average.12

   •  Grafton County has the highest melanoma death rate in the state, 63% higher
      than the national average.11
1 41 All references can be found on the SunWise Web site at:
survivor story: Tina Mangold
              Growing up, I spent a lot of time in the sun and received quite a few blistering
              sunburns. I also used tanning beds as a teenager. That UV exposure caught
              up with me in 2007 when I  noticed a mole on my hand was changing color.
              Fortunately, I already had a dermatology appointment scheduled a few weeks
              later. The day afterthe biopsy, I gotthe news: I had melanoma.

The melanoma was removed from my hand, and two inches of skin were replaced with a graft from
my abdomen. The surgeon also checked for spread of the melanoma by taking a sentinel lymph
node from my armpit. Because the melanoma was detected early, it had not yet spread to my lymph
nodes. I've been cancer-free now for a year and a half.

It's so important to be safe in the sun and to keep your children protected. Now I always wear a
wide-brimmed hat, sunscreen, and sun-protective clothing, and keep out of the midday sun. I make
sure my kids do the same!

Tina Mangold, a Franconia, New Hampshire resident, was 40 years old when she was diagnosed with melanoma.
Melanoma Death Rates,
All Races, Both Sexes, All Ages
  Melanoma Deaths per Year
  per 100,000 People
  Q 2.8-3.1 Q3.2-3.6 H 3.7-4.0
  [2 Suppressed Data
Annual Rate of New
Melanoma Diagnoses,
All Races, Both Sexes, All Ages
 Melanoma Diagnoses per Year
 per 100,000 People

 |  116.5-23.7 | 123.8-31.0 | J31.1 -38.3 ^38.4- 45.5
 \s\ Suppressed Data
 © Recycled/Recyclable—Printed with vegetable oil-based inks on paper that contains at least 50% post-consumer fiber.

     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—a known human carcinogen
   —is the most preventable risk factor for skin cancer.6161923 Taking
   simple steps as early in life as possible can reduce one's risk.2'4'24'25

• Early detection of melanoma can save one's life.26 32 Skin
   examinations may be the best way to detect skin cancer early.2'33'37

• 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.38 39

• Student self-reported data40—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.41

   •  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.41

1~41 All references can be found on the SunWise Web site at:
                               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.