1. SKIN CANCER FACTS • Most common, most rapidly increasing, most preventable cancer • Over 1 million cases in the U.S. estimated for 2002 • 800 melanoma cases are estimated to be diagnosed in Maryland in 2002

2. SKIN CANCER IN MARYLANDEXISTING RESOURCES • Coalition for Skin Cancer Prevention in Maryland, including SunGuard Your Skin curriculum • American Cancer Society • Environmental Protection Agency, SunWise School Program

3. PUBLIC EDUCATION:ADVOCATE FOR SUN SAFE BEHAVIORS • Avoid sun 10am-4pm • Wear protective clothing (long sleeves, long pants, wide brimmed hat) • UVA/UVB protective sunglasses • Avoid tanning beds

4. PUBLIC EDUCATION:ADVOCATE FOR SUN SAFE BEHAVIORS • SPF 15 or higher sunscreen • 20 minutes before exposure • 1 oz per application for adults • Reapply every 2 hours or after swimming/sweating

5. PUBLIC EDUCATION:TARGETING YOUTH/CHILDREN • Target school systems • Promote Maryland State School Health Services Guidelines regarding sun safe policy development (e.g sunscreen in schools) • Include skin cancer prevention as a component of health education curriculum • Target teenagers

6. PUBLIC EDUCATION:TARGETING YOUTH/CHILDREN • Target preschools, child care providers and facilities • Encourage use of sun protective clothing, sunscreen, and use of shade structures • Target Youth organizations: • Girl Scouts, Boy Scouts • 4H

7. PUBLIC EDUCATION:GENERAL POPULATION • Recreation and sport leaders • Outdoor workers • Professional medical community • Non-traditional avenues for educational purposes -Massage therapists • Hairdressers, barbers • Manicurists

8. PUBLIC EDUCATION:HIGH RISK POPULATIONS • Higher risk for incidence: • Fair skinned • Blue or green eyes • Natural blond or red hair • Large number of nevi (moles) • Family history

9. PUBLIC EDUCATION:HIGH RISK POPULATIONS • Higher risk for mortality: • Those diagnosed with later stage melanoma, metastatic melanoma • African-Americans – while incidence is low, need to emphasize self-exam of palms, nails, soles of feet

10. HEALTH CARE PROVIDERS • Primary care providers: • Skin exam as component of annual physical • Refer as needed to specialist/ dermatologist • Patient Education • Sun safety • Skin self exam • Skin cancer

11. HEALTH CARE PROVIDERS • Dermatologists: • Use telemedicine to supplement low availability of dermatologists within rural areas • Encourage dermatologists to participate in annual public screenings

12. POLICY • Schools: • Model legislation based on California’s SB310 which provides for pupils to wear articles of sun protective clothing not limited to hats (outdoors) • Model legislation based on California’s SB 1632 which provides for pupils to use sunscreen during the school day • Encourage funding for provision of shade structures

13. POLICY • Tanning salons • Model legislation based on Texas HB663 which requires the posting of warning signs and regulates the use of tanning salons by those under the age of 18 • Age 13 > - not allowed to use, unless prescribed by physician • Age 13-15 – must be accompanied by parent/guardian • Age 16-17 – written consent by parent/guardian

14. SUMMARY • Use of existing resources in Maryland to promote sun safety • Targeting youth, high risk populations and providers • Initiate policy changes