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Skin Cancer Module: Practice Exercises

	See Also... Skin Cancer Home Module 13: Levels of Disease Prevention Skin Cancer Glossary
	On this Page Summary Figure I Figure II Table I Table II General Questions

Module 14: Summary Exercises

Work through these problems using what you have learned and other EXCITE resources. The problems use cancer statistics collected through SEER. You may want to look back at module 4 and module 5, "Interpreting Cancer Statistics." These modules have information about SEER, definitions, and background information to help you answer the questions.

Figure I

Melanoma Incidence and Mortality Rates for Whites by Sex, 1973-1994

Cutaneous malignant melanoma incidence and mortality rates
Data compiled by H.I. Hall, Division of Cancer Prevention and Control, CDC
[ Text Description ]

Questions

1. What trends do you see in melanoma incidence and mortality? How might you explain these trends?
   
   
2. Why do you think incidence has risen so much more than mortality?
   
   
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.

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Figure II

Age-specific Malignant Melanoma Incidence for White Men and Women

Age-specific cutaneous malignant melanoma incidence for white males
Data compiled by H.I. Hall, Division of Cancer Prevention and Control, CDC

[ Text Description ] 

Age-specific cutaneous malignant melanoma incidence for white females
Data compiled by H.I. Hall, Division of Cancer Prevention and Control, CDC

[ Text Description ]

Questions

1. Think about what you have learned about how melanoma develops. Remember that too much sun in childhood and young adulthood can cause skin cancer later in life. Explain the differences in melanoma incidence in different age groups.
   
   
2. How would primary prevention activities targeted at parents, young children, and teenagers now affect age-specific melanoma rates in the future?
   
   
3. Would skin cancer screening programs affect this graph? If so, how?

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Table I

Average Annual Age-adjusted Melanoma Mortality Rates for Whites by State, United States, 1990-1994

Data compiled by H.I. Hall, Division of Cancer Prevention and Control, CDC

 
^a Rates are "average annual" per 100,000 white population, age-adjusted to the 1970 U.S. standard million, among white population.
^b Standard error.
^c Percent difference between state rate and U.S. average.
^d State mortality rate is significantly different from the U.S. mortality rate.

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Questions

1. Which four states have the highest rates of mortality from melanoma? Are you surprised by the answer? How might you explain it? Use what you know about causes of melanoma, risk factors, and prevention (primary, secondary, and tertiary).
   
   
2. Which states have the lowest rates of mortality from melanoma (<=2/100,000)? Are you surprised by the answer? Why? Why not? Again, suggest a reason for this finding.

Go back to the EPA SunWise website: http://www.epa.gov/sunwise/.

3. Click on the "UV Index" link in the far left column. Find  "Graphs of yearly values for each city." Look at the data for 1998.
   
   
   1. What is the highest UV Index for the state with the highest melanoma mortality rate?
      
      
   2. What is the highest UV Index for the state with the lowest melanoma mortality rate?
      
      
   3. How can you explain this?

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Table II

Age-adjusted Melanoma Incidence for Whites, by Anatomic Site, SEER Areas, 1973–1994^a

Data compiled by H.I. Hall, Division of Cancer Prevention and Control, CDC

Question

1. Where on the body do melanomas most often occur in women? In men? How have these patterns changed over time? Use what you know about causes of melanoma to explain these differences.

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General Questions

1. Think about what you have learned about SEER and about skin cancer. Do you think we can generalize from SEER data about the population of the United States as a whole? How about your state? Your city, town, or county? Your neighborhood?
   
   
2. The figures and tables above only present data on melanoma in white people. Why do you think this is so? (Base your answer on what you know about risk factors for melanoma.) How do you think the results would be different if they included other racial or ethnic groups?

   Test your hypothesis!

   Step 1: Go back to the SEER website (http://seer.cancer.gov).
   Step 2: Under "Fast Stats: Choose a Cancer Site" choose "Melanomas of the Skin."
   Step 3: Find the heading "Incidence" and sub-heading "Line Charts Displaying Age-Adjusted (1970 U.S. Standard Population) SEER Incidence Rates for Individual Years."
   Step 4: Choose "Eleven Registries for 1992–1998 By "Expanded" Race [All Ages]."
   
    

3. How do age-adjusted rates of melanoma vary among different racial groups? Was this what you expected? Base your answer on what you have learned about the risk factors for skin cancer.

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References

1. SunSmart America, Promoting Skin Cancer Prevention and Early Detection. Integrated Lessons for High School Biology Classes.
   Richard David Kann Melanoma Foundation, West Palm Beach, Florida
   561-687-2400

2. Histology a Text and Atlas
   Michael H. Ross and Edward J. Reith
   Harper & Row Publishers, J.B. Lippincott Company, New York, 1985

3. Histology for Pathologist
   Stephen S. Sternberg, MD
   Raven Press, New York, 1992

4. Robbins Pathologic Basis of Disease 5^th ed.
   Ramzi S. Cotran, MD, Vinay Kumar, MD, Stanley L. Robbins, MD
   W.B. Saunders Company, Philadelphia, 1994

5. Hall IH, May DS, Lew RA, Koh HK, Nadel M., Sun protection behaviors of the U.S. white population. Preventive Medicine, 26, 401-407, 1997.

6. Gillchrest BA, Eller MS, Geller AC, Yaar M., The pathogenesis of melanoma induced by ultraviolet radiation. The New England Journal of Medicine, 340(17), 1341-1348, 1999.

7. The Sun Safety Activity Guide
   Environmental Health Center, 1025 Connecticut Ave, NW, Suite 1200
   Washington, D.C. 20036. http://www.nsc.org/ehc.htm*

8. Hall HI and Rogers JD., Sun protection behaviors among African-Americans. Ethn Dis. 9, 126-131, 1999.

9. http://www.skincarephysicians.com*

10. http://www.aad.org*

11. http://www.weather.com*

12. http://seer.cancer.gov

13. http://www.epa.gov

14. http://www.meddean.luc.edu/lumen/MedEd/
    medicine/dermatology/title.htm*

15. http://www.injurypreventionweb.org/info/data/ratenote.htm*

16. http://www.who.int*

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More useful links

American Academy of Dermatology

http://www.aad.org*
http://www.skincarephysicians.com/melanomanet/welcome.htm*

National Council for Skin Cancer Prevention

http://www.skincancerprevention.org*

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Back to Skin Cancer Home

* Links to non-Federal organizations are provided solely as a service to our users. Links do not constitute an endorsement of any organization by CDC or the Federal Government, and none should be inferred. The CDC is not responsible for the content of the individual organization Web pages found at these links.

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