Skin Cancer: A Growing Health Problem for Children

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Objectives

To explore childhood ultraviolet radiation exposure and skin carcinogenesis, review prevention practices, analyze indoor tanning trends, identify skin cancer prevention programs, and address the role of the oncology nurse in youth-focused community initiatives.

Data Sources

Review of the literature, research, and experience.

Conclusion

Skin cancer is an important health problem for children because it is initiated in childhood and melanoma is on the rise in this population.

Implications for Nursing Practice

Nurses can play a pivotal role in reducing the burden of skin cancer through patient education, community outreach, and political action.

Section snippets

Skin Cancer in Childhood

Two national cancer surveillance programs that provide statistics on pediatric cancer in the United States are the National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) program and the Center for Disease Control (CDC) National Program for Cancer Registries' Wonder database. Together they provide information on 96% of the population.10

Approximately 450 new cases of pediatric melanoma will be diagnosed in 2013.11 Melanoma is the only reportable skin cancer and

Overexposure to UVR in Childhood

Children acquire 25% of their lifetime UVR exposure during childhood.24 Overexposure to UVR, via natural and artificial sources, is a known risk factor for skin cancer.1, 3, 25 Sunburns and tanning are commonly seen in children; both are immediate signs of overexposure to UVR.

Multiple studies show that half of all American children experience summer sunburns.9, 26 Factors affecting sunburn risk include increasing age, fair skin, time spent outdoors, sporadic sunscreen use, and inadequate

Indoor Tanning Trends and Teens

The indoor tanning industry, which began in 1978, has grown to a 5 billion dollar business, with more than 1 million Americans tanning daily. In 2009, the World Health Organization added tanning beds to its highest cancer risk category, along with cigarettes and asbestos. This decision was based on an exhaustive review of 19 studies showing "sufficient and compelling" evidence that there was a 75% increased risk of melanoma for individuals who initiated indoor tanning before age 35 years.36

Prevention Campaigns and Curricula

A consortium of skin cancer prevention organizations (45 members) has evolved under the umbrella of the National Council on Skin Cancer Prevention (NCSCP). In 2009, NCSCP launched a national day of sun safety awareness, "Don't Fry Day" (DFD). DFD is held on the Friday before Memorial Day and member organizations conduct activities throughout the United States to engage the public and raise awareness about sun protection and skin cancer prevention. The DFD Webpage lists available resources,

Role of the Oncology Nurse

The US Preventive Services Task Force recommends that fair-skinned children and young adults between ages 10 to 24 years be counseled on minimizing exposure to UVR to reduce their risk for skin cancer.49 Counseling alone, however, is inadequate without teaching "proper" sun protection methods. SunAWARE, an acronym used by many national organizations, incorporates a clear message regarding both primary and secondary prevention. SunAWARE is comprised of five easy, action steps, in order of

Maryellen Maguire-Eisen RN, MSN: Children's Melanoma Prevention Foundation.

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    Maryellen Maguire-Eisen RN, MSN: Children's Melanoma Prevention Foundation.

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