Skin Cancer: Risk and Prevention

What is Skin Cancer?

• Skin cancer is an uncontrolled growth of

abnormal skin cells. It most often develops on

areas of the skin exposed to the sun’s rays.

• In the US, more people are diagnosed with skin

cancer each year than ALL other types of cancer

combined.

• Rates of incidence of all types of skin cancer

have increased dramatically in the past three

decades, and continue to increase each year.

• However, skin cancer is also the easiest cancer

to be treated, especially when detected early,

and is less likely to be fatal than many other

cancers.

• Skin cancer is the most common form

of cancer in the United States.

• The two most common types of skin

cancer—basal cell and squamous cell

carcinomas—are highly curable, but

can be disfiguring and costly to treat.

• Melanoma, the third most common

skin cancer, is more dangerous and

causes the most deaths.

• The majority of these three types of

skin cancer are caused by

overexposure to ultraviolet (UV) light,

most commonly through sunlight or

tanning beds.

Types of Skin Cancer

Indicators of skin cancer may include:

● Irregular borders on moles (ragged,

notched, or blurred edges)

● Moles that are not symmetrical (one

half doesn’t match the other)

● Colors that are not uniform throughout

● Moles that are bigger than a pencil

eraser

● Itchy or painful moles

● New moles

● Sores that bleed and do not heal

● Red patches or lumps

Screening for Skin Cancer

The treatment and prognosis of skin cancer varies widely, depending on which type and how early it is detected.

• Basal Cell Carcinoma (BCC) is the most common skin cancer. It grows very slowly and almost never metastasizes.

• Most BCCs can be treated and removed with minor surgery or other local treatment.

• The goals of treatment are to completely remove all cancer cells while preserving the function and appearance of the affected body part.

• The cure rate when BCC is removed surgically can be as high as 91 to 98%.

• Advanced BCC is so rare that there is very little information about survival rates.

Treatment and Prognosis

• Squamous Cell Carcinoma (SCC) is the second most common skin cancer. Most cases are easily treated; however, SCC is more likely than BCC to be invasive and metastatic.

• When SCC is found early—and most are—treatment usually cures this cancer.

• Various methods used to surgically remove SCC tumors have a typical cure rate of 92 to 97%

• About 5% to 10% of SCC cases are “high-risk” or likely to grow back or spread.

• Unfortunately, because cases of SCC are not reported to cancer registries it is difficult to estimate survival rates. It is clear that if SCC does metastasize, it becomes very difficult to treat and far more likely to result in death.

Treatment and Prognosis

• Melanoma is a less common type of skin cancer, but it is more dangerous. Melanoma is more likely to invade deeper layers of skin and spread to other body parts.

• Most melanomas can be treated and removed with surgery if they are caught early.

• Melanomas are removed with a procedure called wide excision, wherein the surgeon removes the entire tumor, along with some of the healthy skin surrounding it. The purpose is to remove any cancer cells that might have spread, reducing the risk that the tumor will recur.

• The 5-year survival rate for melanoma depends greatly on which stage the cancer is in when treatment begins. It can range anywhere from 17.9% to 98.4%.

• Early detection is key!!

Treatment and Prognosis

• Skin cancer affects people of all colors and

races, although those with light skin who

sunburn easily have a higher risk.

• Sun damage is cumulative, meaning that more

time spent in the sun daily continues to increase

risk of skin cancer over years of a lifetime.

• Reflection from bright surfaces like concrete,

metal, snow, or sand can increase total sun

exposure.

• Outdoor laborers are at an increased risk for

skin cancer, but because the risk is gradual and

not as immediate as the risks of accidental

death or injury, skin protection is often

overlooked as a workplace safety issue.

Skin Cancer Risk

• The National Weather Service and the Environmental Protection Agency developed the UV Index to forecast the risk of overexposure to UV rays.

• The UV Index lets you know how much caution you should take when spending time outdoors that day.

• The UV Index predicts exposure levels on a 0 to 15 scale; higher levels indicate a higher risk of overexposure.

• If the UV index is 3 or higher, sun protection is needed - even if it is not a sunny day.

UV Index

• Clothing is a first line of

defense. Cover as much skin as

possible when spending time

outside.

• Other safety gear that blocks

the sun should also be used. For

example, a flap of fabric can be

attached to the back of hard

hats to protect the neck, and

wearing sunglasses or safety

glasses that filter out UV rays

should be encouraged.

Prevention: Clothing

• Sunscreen should be applied to all

remaining exposed skin.

• It is recommended that everybody

wear sunscreen of at least SPF 15,

every day. Doing so cuts the risk of

melanoma developing later on by

50%, and can also decrease skin

aging.

• When spending a significant

amount of time outside, prepare by

applying sunscreen of SPF 30 or

higher, 20 minutes in advance.

Prevention: Sunscreen

• Seek shade as much as possible, and

avoid working in direct sunlight.

• The sun is most intense during the

hours of 10am to 4pm, so it is

especially important to protect skin

and avoid extended time in the sun

during those hours.

• If working in direct sunlight is

unavoidable, be sure to take

frequent breaks in the shade to cool

down, drink water, and reapply

sunscreen.

Prevention: Shade

Employers can adopt these strategies and

others to keep outdoor workers safer from

exposure to the sun:

• Offer training on sun safety, or include it

in existing wellness programs.

• Provide sunscreen and other protection,

such as hard hat flaps, at all work sites.

• Increase shade at the worksite by

providing tents, shelters, and cooling

stations.

• Decrease UV reflection by covering shiny

or reflective surfaces.

Prevention: Employers

Other ways employers can keep outdoor

workers safer from sun exposure:

• Schedule frequent breaks in the shade

and give workers time to reapply

sunscreen.

• If possible, schedule outdoor work before

10am or after 4pm to reduce time spent

working in the most intense sunlight.

• Post each day’s UV Index and what level

of protection is needed.

• Rotate workers to reduce each person’s

UV exposure time.

Prevention: Employers