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Science Olympiad» Disease Detectives Event » National Event Exercises
Skin Cancer Module: Practice Exercises



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Module 13: Levels of Disease Prevention
Skin Cancer Glossary
   

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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, CDCFigure I
[ 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.

See Answers to Questions

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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
Figure II, white males
[ Text Description

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

See Answers to Questions

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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

State

Number of Deaths

Mortality Ratec

Male

Female

Total

SEb

PDc

Alabama

530

3.90

1.90

2.80

0.12

12

Alaska

33

1.90

2.20

2.20

0.44

-12

Arizona

533

3.50

1.70

2.50

0.11

0

Arkansas

321

3.10

1.80

2.40

0.14

-4

California

3745

4.00

1.90

2.80

0.05

12.0d

Colorado

466

3.60

1.90

2.70

0.13

8

Connecticut

457

3.20

1.90

2.40

0.12

-4

Delaware

116

4.50

2.60

3.50

0.33

40.0d

Dist. of Columbia

23

2.40

1.70

2.10

0.45

-16

Florida

2284

4.00

1.50

2.60

0.06

4

Georgia

747

4.00

1.80

2.80

0.10

12.0d

Hawaii

48

4.50

2.00

3.30

0.48

32

Idaho

140

3.70

1.30

2.40

0.21

-4

Illinois

1284

3.00

1.60

2.20

0.06

-12.0d

Indiana

711

3.30

1.60

2.30

0.09

-8

Iowa

379

2.80

1.40

2.10

0.11

-16.0d

Kansas

379

3.40

1.90

2.60

0.14

4

Kentucky

490

3.30

1.60

2.40

0.11

-4

Louisiana

398

3.30

1.70

2.40

0.12

-4

Maine

170

3.20

1.50

2.30

0.18

-8

Maryland

543

3.90

1.60

2.60

0.11

4

Massachusetts

962

3.90

2.10

2.80

0.09

12.0d

Michigan

918

2.70

1.40

2.00

0.07

-20.0d

Minnesota

479

2.60

1.40

1.90

0.09

-24.0d

Mississippi

215

3.00

1.30

2.00

0.14

-20.0d

Missouri

724

3.50

1.80

2.50

0.10

0

Montana

105

2.70

1.80

2.20

0.22

-12

Nebraska

197

2.80

1.50

2.10

0.16

-16

Nevada

205

3.90

2.30

3.10

0.22

24

New Hampshire

152

3.50

1.70

2.50

0.21

0

New Jersey

1141

3.90

1.80

2.70

0.08

8

New Mexico

195

3.50

1.70

2.50

0.18

0

New York

2082

3.20

1.60

2.30

0.05

-8.0d

North Carolina

938

4.10

2.10

2.90

0.10

16.0d

North Dakota

72

2.10

1.50

1.70

0.22

-32.0d

Ohio

1337

3.20

1.60

2.30

0.06

-8.0d

Oklahoma

492

4.00

1.90

2.90

0.13

16

Oregon

463

3.40

2.00

2.60

0.13

4

Pennsylvania

1761

3.40

1.70

2.40

0.06

-4

Rhode Island

132

3.00

1.30

2.10

0.19

-16

South Carolina

402

4.30

1.50

2.70

0.14

8

South Dakota

99

3.30

1.60

2.40

0.25

-4

Tennessee

714

3.80

1.90

2.80

0.10

12

Texas

1923

3.40

1.60

2.40

0.06

-4

Utah

221

3.90

2.00

2.90

0.20

16

Vermont

95

4.00

2.10

3.00

0.32

20

Virginia

768

3.60

2.00

2.70

0.10

8

Washington

635

3.30

1.70

2.40

0.10

-4

West Virginia

288

3.30

1.80

2.50

0.15

0

Wisconsin

572

2.70

1.40

2.00

0.09

-20.0d

Wyoming

63

4.00

1.40

2.60

0.33

4

Totals:

32147

3.50

1.70

2.50

0.01

 

 
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/.

  1. 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?

See Answers to Questions

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Table II

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

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

Site

1973-1974

1975-1979

1980-1984

1985-
1989

1990-
1994

Males

 

 

 

 

 

Head & Neck

1.7

2.0

2.6

3.5

4.1

Trunk

2.5

3.6

4.8

6.0

6.7

Upper limb

1.3

1.7

2.3

2.9

3.4

Lower limb

0.8

0.9

1.1

1.2

1.5

Unspecified

0.5

0.6

0.9

0.9

1.0

Females

 

 

 

 

 

Head & Neck

1.0

1.1

1.3

1.3

1.5

Trunk

1.1

1.8

2.2

2.8

3.0

Upper limb

1.5

2.0

2.5

2.7

3.0

Lower limb

2.2

2.6

3.3

3.6

3.7

Unspecified

0.4

0.3

0.4

0.5

0.5

a Rates are "average annual" per 100,000 white population, age-adjusted to the 1970 U.S. standard million, among white population. SEER is the Surveillance, Epidemiology, and End Results program of the National Cancer Institute.

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.

See Answer to Question

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.

See Answers to Questions

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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 5th 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.





This page last reviewed April 24, 2007

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