Action Plan on Skin Cancer for Texas : Background Paper : VIII




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

VIII. Professional practice affecting skin cancer prevention, detection, and treatment

A. Knowledge and practice patterns of health care practitioners
Since MM can develop in areas not exposed to the sun, health care practitioners should routinely perform full skin exams. Increased awareness on the part of health care providers encourages them to instruct their patients on skin cancer awareness and prevention.

An informal survey conducted as part of the development of this action plan was sent to 712 primary care physicians in Texas (response rate of 20%), with the following results:


•	The more screening respondents did, the more skin cancer they found.
•	41% of respondents reported skin cancer screening was not emphasized in their medical training.
•	The barriers that prevented full-body screening were, in order of priority, time, patient embarrassment, and reimbursement.

These results may be compared with those reported in a Florida and Connecticut survey which showed that 50% of respondents did no skin cancer screening at all, and fewer than 30% of the respondents reported that skin cancer screening was emphasized during their training. [ 31 ]

B. Current training and continuing education curricula for health care providers
Curricula for the following health care practitioners should address skin cancer awareness, prevention, and detection: physicians, nurse practitioners, nurses, physician assistants, dentists, dental hygienists.

C. Opportunities for skin cancer awareness and detection education
Education of health and beauty industry professionals
Members of public service occupations in fields such as cosmetology, etc. are in an ideal situation to observe the skin of their clients over time. Skin cancer awareness would enable them to assist their clients in recognizing the need to seek medical advice for changing skin cancer lesions.