Preface Contents 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 Bibliography Appendix   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
		Goal II: Develop prevention information and services to increase public awareness
		Objective A. Approach and enlist potential coalition partners (public, private, and volunteer agencies and health care providers) whose collaborations will contribute to reducing the incidence of skin cancer in Texas.
			Strategy 1 Demonstrate the scope of the problem to potential coalition partners to illustrate the urgency of the situation.
			Strategy 2 Partner with public and private organizations skilled at community coalition building.
		Objective B. Develop and disseminate a consistent skin cancer awareness message, tailored to Texas, that incorporates an accurate statement of the scope of the problem and prescribes behavior changes that can reduce risk immediately and alter the disease burden over time.
			Strategy 1 Adapt basic message to serve major culture and language groups in Texas.
				Enlist use of the advertising industry to develop effective messages.
			Strategy 2 Maintain a year-round, consistent, media campaign.
				Facilitate logistics through coalition members.
			Strategy 3 Educate public about recognition of signs and symptoms of skin cancer and encourage them to ask health care providers for skin assessment.
				Partner with organizations such as the ACS (volunteer) and NCI (public) to distribute skin self-exam instructions in Texas as part of their public information campaigns.
			Strategy 4 Partner with community educational organizations to deliver information to high risk or hard to reach populations.
		Objective C. Provide information to policy makers at the local and state level.
			Strategy 1 Raise awareness with appropriate policy makers that excess sun exposure is an occupational hazard for outdoor workers.
				Encourage work-place safety regulations that consider peak UV radiation exposure times, and develop and disseminate guidelines for availability and use of sunscreen, protective clothing, and shade structures.
			Strategy 2 Raise awareness with appropriate policy makers that excess UV radiation exposure presents a skin cancer hazard in public recreation areas.
				Encourage the posting of information that advocates sun protective behavior, including sun-screen use, at public recreational facilities such as parks, lakes, and beaches.
		Objective D. Provide skin cancer information to educators at every level, including the Texas State Board of Education, school superintendents, school principals, classroom teachers, athletic directors, and coaches.
			Strategy Promote regulation of school activities to incorporate the practice of sun-safe behaviors, such as: avoiding outdoor activity at times of peak UV radiation, utilizing shade structures, applying sunscreen, and wearing protective clothing and head gear.
				Encourage coaches for all age groups to equate sun-safe practices with heat-related injury prevention measures, so that sunscreen reapplication breaks become as much a feature of athletic events and practices as water breaks.
			Strategy 2 Raise awareness with appropriate policy makers that excess UV radiation exposure presents a skin cancer hazard in public recreation areas.
				Encourage the posting of information that advocates sun protective behavior, including sun-screen use, at public recreational facilities such as parks, lakes, and beaches.
		Objective E. Provide skin cancer information to directors of organized outdoor youth activities such as summer camps and outdoor recreation programs (swimming and team sports).
			Strategy Educate counselors, coaches, and participants about skin cancer prevention measures so that they may put them into practice.
		Objective F. Recommend inclusion of skin cancer prevention awareness in training o ffered to day-care workers.
			Strategy Recommend a classification of sunscreen as an ointment so that it may be applied to children by day-care workers.
		Objective G. Encourage the Texas State Board of Education to include skin cancer prevention and awareness as a part of the mandated curriculum in the K-12 Texas Essential Knowledge and Skills (T.E.K.S.)
			Strategy Recommend that skin cancer awareness become part of the teacher EXCET tests (teacher certification tests).
		Objective H. Educate policy makers concerning the hazards of non-medical use of ultraviolet radiation (UV Radiation).
			Strategy Strengthen and enforce existing regulations for commercial tanning beds.