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Action Plan logo
Executive Summary
Background Paper
  I. Incidence, mortality, and impact on society
II. Skin cancer
III. Contributing and causative factors
IV. Prevention
V. Cancer prevention and information services that impact the skin cancer problem
VI. Barriers to early detection and treatment of skin cancer in Texas
VII. Policy initiatives that would affect skin cancer awareness and prevention
VIII. Professional practice regarding skin cancer prevention, detection, and treatment
IX. Prevention and information models
Action Plan
  Goal I Initiate data collection and analysis
  Goal II Develop prevention information and services to increase public awareness
  Goal III Enhance professional education and practice
  Goal IV Improve access to prevention, detection, and treatment
  i. Melanoma of the Skin Incidence and Mortality Rates, 1988-1992
ii. Five-Year Relative Survival Rates, by Site 1986-1992
iii. Average Years of Live Lost per Person Dying of Cancer, 1993
iv. Demographic Characteristics of Patients Diagnosed with Malignant Melanoma of the Skin
v. Counties Reporting Health Care Availability as an Issue
vi. Federally Designated Medically Underserved Areas
vii. Additional Texas Cancer Council Initiatives
  Action Plan title
Goal I:
Initiate data collection and analysis

Objective A.
Identify scope of the problem
  Strategy 1
Develop a mechanism for collecting data on new cases of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in Texas.
  a) Consider methodology of available statistics for BCC and SCC when planning data collection. Data collection should utilize available diagnosis re c o rds for these two cancers fro m Federal and State healthcare programs, and private insurance companies.
b) Create an incentive for health care providers to report incidence electronically from practice sites, including partnering with a stakeholder corporation to provide computer equipment and sponsor a web site for gathering data. Examples include collecting data via diagnosis code from dermatologists, pathologists, internal medicine and family medicine health care providers, as well as the Texas Dermatological Society, and the American Academy of Dermatology.
Strategy 2
Develop a mechanism to determine the financial and social impact of BCC, SCC, and malignant melanoma (MM) in Texas.
  a) In BCC and SCC, consider cost of delayed treatment in terms of actual treatment costs, both for timely and deferred treatment, including measurement of quality of life reduction due to deformity or metastasis; costs resulting from time away from work, loss of productivity.
b) In MM, utilize readily available statistics of MM incidence and mortality, and consider cost of: immediate and delayed treatment, death from preventable cancer, years of productive life lost, social programs to offset unemployment, and aid for dependent families.

Objective B.
Develop screening guidelines that are appropriate for Texas.
Review current national (AAD, ACS and NCI) guidelines and adapt these for Texas.
  Incorporate consideration of average yearly ultra violet radiation (UV Radiation) levels in Texas, skin type, family history, length and frequency of occupational and re c reational sun exposure, and exposure to UV radiation from any source, including tanning beds.

Objective C. Document the effectiveness skin cancer detection and prevention programs in Texas.
Study methodology and outcomes measurements of existing screening and prevention programs in Texas.
  Consider incidence trends revealed through studies and cost-effectiveness of early detection and treatment.
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