Faculty Bibliography

Malignant melanoma continues to present a significant public health problem as its incidence is rising faster than that of any other cancer in the US. At current rates, 1 in 74 Americans will develop melanoma during his or her lifetime. Management of melanoma is a complex issue requiring a multidisciplinary approach. The most effective method of protection against the development of melanoma is minimization of ultraviolet exposure from sunlight. Early detection and treatment are critical and result in improved patient survival rates. Surgical excision remains the mainstay of treatment but many new promising therapies are being investigated. It is hoped that increased public and professional awareness and education in all areas relating to the prevention, detection, and treatment of malignant melanoma will contribute to decreasing trends in the incidence and mortality from this cancer in the future

BACKGROUND: Because an estimated 50% to 80% of the skin's lifetime sun damage is thought to occur in childhood and adolescence, it is during these critical periods that intense, intermittent sun exposure causing burning increases melanoma risk. METHODS: A 1997 telephone survey of 503 households evaluated parental attitudes about their child having a tan, and ease of practicing sun protection, sun protection methods used, and sunburning on 5 successive summer weekends. RESULTS: In a random sample of 1 child from each household, 13% of children sunburned during the past week or weekend, and 9% of their parents experienced a sunburn during the past weekend. Children's sunburn was significantly associated with sunburn in the adult respondent, increasing age of the child, having fair skin, being white, and using sunscreens. Duration and peak hours of sun exposure were associated for children and parents. Sunscreen with a sun protection factor of at least 15 was the predominant form of sun protection used. Sunscreen use in children was significantly associated with longer duration of sun exposure, sunny weather conditions, younger age, fair skin, a history of sunburns before this study, a family history of skin cancer, and a higher family income. Feeling that a tan appeared healthy was associated with male gender of the adult and increasing age of the child. Complimenting the child on the appearance of a tan was associated with male gender of the adult, older children, children with skin type reported as olive or dark, and lower educational levels. CONCLUSION: Although there has been a promising initial effort to alert parents to the need to protect their children from sunburns, many view a tan as healthy and do not effectively implement sun protection behaviors for their children, which results in sunburns. Sun protection that prevents sunburning could be achieved by more children seeking shade, wearing protective clothing, limiting exposure during peak hours, and effectively using sunscreen