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Skin Cancer: Module
14
Figure I Questions
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Question 1: What
trends do you see in melanoma incidence and mortality? How might you explain
these trends?
Answer:
Both
incidence and mortality rates for melanoma have gone up a lot from the
mid-1970s to the mid-1990s. Incidence went up more for white males (from
6.4 to 14.0 per 100,000) than for white females (from 6.1 to 11.6 per
100,000). The mortality rate also went up more for males than for females.
And the mortality rate for males in 1994 was twice as high as the rate
for females. The rising incidence of melanoma is probably due to more
exposure to ultraviolet (UV) rays. Cultural changes that bring people
outdoors more may be part of the problem. Also, tanned skin became stylish
during this time. People take more vacations to sunny places than before,
too. These trips expose them to short bursts of strong sun. Depletion
of the ozone layer also causes more UV exposure. This may be a factor
in skin cancer incidence, too.
Question 2: Why
do you think incidence has risen so much more than mortality?
Answer:
Melanoma can be cured if detected early. The mortality rate of
melanoma can be kept from rising as quickly as the incidence rate through
- treatment
advances
- more detection
of early tumors
- In the
case of melanoma, detection of early tumors plays more of a role in
the rise in incidence than treatment advances
Question 3:
Think about what you have learned about the causes of melanoma. How
could the incidence of melanoma in this population be brought down? How
could mortality from melanoma be decreased? In your answer, show that you
understand the difference between primary, secondary, and tertiary
prevention. And describe things that could be done at each of these
levels.
Answer: Incidence of melanoma could be prevented through primary
prevention. Protecting one's skin from UV rays is the best way to prevent
melanoma. Primary prevention of melanoma could involve teaching sun-safe
habits:
- avoiding the outdoors during peak sun hours
- seeking shade
- using protective clothes/hats
- wearing sunscreen
School, government, and community policies can also support primary
prevention. For example:
- planting trees or building shade structures at schools and public
buildings
- planning outdoor events for more sun-safe times
Secondary prevention could ideally bring mortality rates down. However,
to date, skin cancer screening has not been shown to decrease the
mortality (http://www.ahrq.gov/clinic/ajpmsuppl/skcarr.htm).
Tertiary prevention through treatment advances would also bring
mortality rates down.
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