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What Comprehensive Cancer Control Programs Can Do About Indoor Tanning Among Minors

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CDC’s National Comprehensive Cancer Control Program (NCCCP) helps prevent and control cancer in the United States by supporting states’ efforts to—

  • Develop data-driven cancer control plans.
  • Establish and convene statewide cancer-fighting coalitions.
  • Implement and evaluate a state cancer control plan.


Collect and Analyze Data

  • Conduct an environmental scan to identify indoor tanning legislation in your jurisdiction. Most of this information may be available online.
  • Collaborate with your state’s Youth Risk Behavior Survey (YRBS) coordinator to add a question on indoor tanning to the state-level YRBS if it is not already included (see Box 1).
  • Use YRBS data to monitor indoor tanning among high school students in your state.
  • Use cancer registry data to examine melanoma incidence and death rates in your jurisdiction, emphasizing trends over time by age group and race/ethnicity.
  • Explore other data that may be available for analysis, such as administrative data on the number and locations of salons and other businesses in your jurisdiction that provide indoor tanning.
  • Monitor changes in this data over time, which may provide insight into the effectiveness of your efforts to reduce indoor tanning among minors.52
  • Consider developing a special survey to examine a related topic such as a survey to examine skin cancer prevention counseling practices of primary care physicians in your area.

Box 1. State Youth Risk Behavior Survey (YRBS): Potential indoor tanning question

The prevalence of indoor tanning among high school students in your state can be estimated by including the following question:

During the past 12 months, how many times did you use an indoor tanning device such as a sunlamp, sunbed, or tanning booth? (Do not count getting a spray-on tan)

  1. 0 times
  2. 1 or 2 times
  3. 3 to 9 times
  4. 10 to 19 times
  5. 20 to 39 times
  6. 40 or more times

Identify and Engage Potential Partners

  • Educate CCC coalition members on melanoma rates and trends in your jurisdiction.
  • Identify potential partners, both local and national, and engage them in efforts to educate key stakeholders on strategies to reduce indoor tanning among minors.
  • Provide partners with up-to-date data and trends.
  • Provide information upon request to partners and stakeholders within your jurisdiction.
  • Encourage melanoma survivors, including adolescent (with parental permission) and young adult survivors, to share their stories and serve as champions for skin cancer prevention in your community.
  • Share other resources such as CDC’s Burning Truth communication initiative, CDC’s Truth About Tanning infographic, CDC’s Sun Safety for America’s Youth toolkit, and EPA’s state skin cancer fact sheets with the appropriate partners.
  • Partner with health systems and medical societies to promote USPSTF recommendations on behavioral counseling to prevent skin cancer and screening for skin cancer (see Box 2).53
  • Survey key partners to identify their needs as well as resources they can contribute to your efforts.
  • Partner with local colleges and universities to develop and evaluate strategies to reduce indoor tanning.

Box 2. U.S. Preventive Services Task Force (USPSTF) recommendations related to skin cancer prevention

Behavioral Counseling to Prevent Skin Cancer
Released May 2012

  • The USPSTF recommends counseling children, adolescents, and young adults aged 10 to 24 years who have fair skin about minimizing their exposure to ultraviolet radiation to reduce risk for skin cancer.
    Grade: B Recommendation
  • The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of counseling adults older than age 24 years about minimizing risks to prevent skin cancer.
    Grade: I Statement

Screening for Skin Cancer
Released February 2009

  • The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of using a whole-body skin examination by a primary care clinician or patient skin self-examination for the early detection of cutaneous melanoma, basal cell cancer, or squamous cell skin cancer in the adult general population.
    Grade: I Statement

Measure Effect

Developing and implementing an evaluation plan is essential to measuring the effect of your CCC program’s efforts to reduce indoor tanning among minors and ultimately prevent future cases of skin cancer. Evaluation also can help you track progress toward meeting the goals in your jurisdiction’s cancer plan. In addition, the findings from your evaluation can inform the selection of strategies in other states.

  • The state YRBS monitors priority health risk behaviors among high school students in most states and territories biennially. After a question about indoor tanning has been added to your state’s YRBS, you can use the resulting data to estimate the prevalence of indoor tanning among high school students in your state. You can also compare your state data to estimates from the national YRBS.
  • Library of Indicators (LIDS) allows users to find appropriate indicators that can be used to develop objectives and indicators for evaluation within cancer plans and action plans. LIDS includes indicators and data sources for both indoor tanning and sun safety practices.
  • The CCC Evaluation Toolkit provides guidance on how to plan and conduct evaluations. Plans for evaluation should be developed at the beginning of any public health effort. This ensures that appropriate evaluation questions are developed and that data sources are in place to capture baseline information before intervention activities begin.
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