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Melanoma pp 271-286 | Cite as

Prevention of Cutaneous Melanoma

  • Craig SinclairEmail author
  • Louise F. Wilson
  • Catherine Olsen
  • Anna Nicholson
Reference work entry

Abstract

The disease burden associated with melanoma continues to be a significant public health problem. The main modifiable risk factor for cutaneous melanoma is exposure to ultraviolet radiation, whether from the sun or artificial sources such as tanning sunbeds. Here we discuss the evidence for primary prevention and early detection of melanoma, commencing with an historical account of early skin cancer prevention programs and tools such as the Solar UV Index.

At a population level, there is sufficient evidence to support multicomponent, community-wide skin cancer prevention interventions (such as mass media campaigns, environmental and legislative interventions) and those that target certain settings. Legislative controls that restrict access to artificial tanning sunbeds can be effective in reducing the number of visitations by young people, thus reducing their risk of melanoma. Considering behavioral strategies, there is a lack of high-quality evidence for the effectiveness of recommendations to seek shade, cover exposed skin with clothing, wear a hat and sunglasses, and to regularly apply sunscreen with a SPF of 15 or higher when outdoors in the sun; however, this is largely due to limitations of the available epidemiological data. There is also lack of evidence that mass screening programs reduce mortality and medical costs due to melanoma, which are important principles of any population-based screening program. Globally, most skin cancer detection guidelines encourage regular self-examination, together with education regarding sun protection and whole body skin examination by a clinician in the presence of any change or concern.

In summary, there is reasonable evidence to suggest that reducing melanoma incidence through evidence-based prevention and early detection interventions is not only likely to be effective in reducing the risk of melanoma at a population level but will also be cost-effective. In Australia, where skin cancer prevention programs were established in the 1980s, melanoma incidence is now declining among younger adults, which most likely reflects changing patterns of sun exposure and the success of primary prevention efforts in recent decades. At a time when the cost of treating melanoma is likely to increase significantly in coming years, now is the time to make the necessary investments to reduce the growing and significant human and financial burden of melanoma into the future.

Keywords

Melanoma Skin cancer prevention Sunscreen Sunbeds Early detection Melanoma screening Ultraviolet radiation Health promotion 

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Craig Sinclair
    • 1
    Email author
  • Louise F. Wilson
    • 2
  • Catherine Olsen
    • 2
    • 3
  • Anna Nicholson
    • 1
  1. 1.Center for Behavioural Research in CancerCancer Council VictoriaMelbourneAustralia
  2. 2.Cancer Control GroupQIMR Berghofer Medical Research InstituteHerstonAustralia
  3. 3.School of Public HealthThe University of QueenslandBrisbaneAustralia

Section editors and affiliations

  • David E. Fisher
    • 1
  • Nick Hayward
    • 2
  • David C. Whiteman
    • 3
  • Keith T. Flaherty
    • 4
  • F. Stephen Hodi
    • 5
    • 6
  • Hensin Tsao
    • 7
    • 8
  • Glenn Merlino
    • 9
  1. 1.Department of Dermatology, Harvard/MGH Cutaneous Biology Research Center, and Melanoma Program, MGH Cancer CenterMassachusetts General Hospital, Harvard Medical SchoolBostonUSA
  2. 2.QIMR Berghofer Medical Research InstituteHerstonAustralia
  3. 3.QIMR Berghofer Medical Research InstituteHerstonAustralia
  4. 4.Henri and Belinda Termeer Center for Targeted TherapiesMGH Cancer CenterBostonUSA
  5. 5.FraminghamUSA
  6. 6.Department of Medicine, Brigham and Women's HospitalDana-Farber Cancer InstituteBostonUSA
  7. 7.AuburndaleUSA
  8. 8.Harvard-MIT Health Sciences and TechnologyCambridgeUSA
  9. 9.Center for Cancer ResearchNational Cancer InstituteBethesdaUSA

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