Office of Air and Radiation (6205J)    EPA-430-M4-008   April 2014
survivor story:

Raymond Kosaka

              I was first diagnosed with skin
              cancer in September of 2010.
              While getting a haircut, my
              barber noticed a discoloration
            3  on my scalp on the top of my
              head.  I waited two months
until my next semi-annual physical exam to
have the area evaluated by a doctor. The
result: Stage I melanoma.

As a teen, I spent hours in the summer sun free
diving, and as an adult I've spent many years as a
sport fisher, often with nothing to protect my bare
head. Since being diagnosed with melanoma,
I've undergone two surgeries—one by my
dermatologist to remove the discoloration on my
scalp, and a second by an oncologistto remove a
larger area of skin. I've been "cancer-free" since.

I've made several changes since the
diagnosis—I now wear a cap while in the
sun and tell my family and friends to protect
themselves at all times while outside. In addition,
I've learned to take observations of others,
like my barber, seriously, and to see my doctor
immediately to have any skin changes examined.
And of course, I made sure to send my barber a
bouquet of flowers and to tip her generously!

Raymond Kosaka, a Honolulu, HI resident, was 75 years
old when diagnosed with melanoma.
Skin cancer is the most common cancer diagnosed

in the  United States.1"5 This fact sheet presents statistics

about skin cancer for Hawaii and the United States.

just the facts:  Skin Cancer in  Hawaii

• Sunburns. A survey conducted in 2012 found that more than 29% of White adults
   in Hawaii had experienced at least one sunburn in the past year.6 Sunburns are a
   significant risk factor for the development of skin cancer.4'7"10

• New Cases of Melanoma. An estimated 380 residents of Hawaii will be
   diagnosed with melanoma in 2013.3 Although melanoma is not the most common
   type of skin cancer, it is the most deadly—responsible for about 75% of all
   deaths from skin cancer.3'"
   •  Hawaii has the highest rate of new melanoma diagnoses nationwide among
      Whites, who are at the highest risk for melanoma. The rate of new melanoma
      diagnoses among Whites in Hawaii is nearly triple the national  average.12'13
   •  The rate of new melanoma diagnoses for men is rising faster than that of any
      other cancer—increasing on average by 4% per year between  2005 and 2009.12
   •  The rate of new melanoma diagnoses in Maui, Hawaii, and Kauai counties is
      higher than the national average; in Maui County, the rate is nearly double the
      national average.12

• Deaths from Melanoma. Nearly 75 people died of melanoma in Hawaii between
   2005 and 2009.14
   •  Melanoma has the third fastest rising death rate among cancers in Hawaii.15
   •  Hawaii is tied with Alabama for the highest death rate from melanoma
      nationwide among Whites. The death rate from melanoma in Hawaii was more
      than 30% higher than the national average in 2009.15'16
1~44 All references can be found on the SunWise Web site at: www.epa.gov/sunwise/statefacts.html
Annual Rate of New Melanoma Diagnoses, 2005-2009"
All Races, Both Sexes, All Ages
           


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     The  Cost of Skin  Cancer
                                        __
            In the United States, medical costs to treat

            melanoma skin cancer in 2010 were estimated

            at almost $2.4 billion. These costs are projected

            to reach at least $3.2 billion by 2020.17
statistics:  Cause for Concern

• More than 3.5 million cases of skin cancer are
   diagnosed each year,2 making it the most common
   of all cancers in the United States.135 More people
   will be diagnosed with skin cancer in 2013 than the
   number diagnosed with breast, prostate, lung, and
   colon cancers combined.3 Without a reduction in skin
   cancer incidence rates, about 1 in 5 non-Hispanic
   Whites will get skin cancer in their lifetime.18

• One American dies of melanoma every hour.3

• Melanoma is the most commonly diagnosed cancer
   and the second leading cause of cancer death for
   young adults 25-29 years old.19

• For people born in 2009,1 in 50 will be diagnosed
   with melanoma19—nearly 30 times the rate for
   people born in the 1930s.20
            National Annual Rate of New Melanoma Diagnoses, 2005-200912
            All Races, Both Sexes, All Ages, Age-adjusted Rates
               -SAK
             Melanoma Diagnoses perYear per 100,000 People

             D8.5-16.2 D16.3-18.7 Dl8.8-20.7 •20.8-22.5  •22.6-29.8
            * 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 50 states and D.C., four quintiles include ten states, and one quintile includes eleven. For example, the eleven states
             with the highest melanoma rates—22.6 to 29.8 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.72126
   Taking simple steps as early in life as possible can reduce one's risk.3'5'27'28

• Early detection of melanoma can save one's life.29 35 Skin examinations
   may be the best way to detect skin cancer early.3'36-40

• 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.4142

• Student self-reported data43—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.44

   •  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.44

1~44 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 30 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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