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Arnold School of Public Health

Anthony Alberg leads development of policy statement on skin cancer prevention for American Society of Clinical Oncology

June 8, 2020 | Erin Bluvas,

The United States and many other countries are experiencing an epidemic of skin cancer, which has become the most commonly diagnosed cancer both nationally and around the world. As the leading organization for physicians and oncology professionals caring for people with cancer, the American Society of Clinical Oncology convened a committee of experts to write a policy statement on the prevention of skin cancer, including strategies and recommendations for addressing this epidemic.

Anthony Alberg, the chair of the Arnold School’s Department of Epidemiology and Biostatistics and an internationally renowned cancer epidemiologist, chaired this committee. He also served as lead author on the resulting policy statement, which was published in JCO Oncology Practice.

The annual healthcare costs of treating skin cancer total an estimated $8.1 billion in the United States alone. This growing public health challenge can cause disfigurement, impaired function, and death and most commonly occurs in the form of melanoma or two types of keratinocyte carcinoma: basal cell and squamous cell. Particularly dangerous due to its ability to metastasize, melanoma causes the most deaths and increased by 300 percent between 1975-1979 and 2016, according to the National Cancer Institute’s SEER cancer registry.

With this policy statement, the American Society of Clinical Oncology affirms its support and commitment to policies aimed at lessening the burden of skin cancer through reducing exposure to UV radiation. The authors organize the Society’s recommendations into four areas: indoor tanning, sun-protection promotion, community education and outreach, and the role of the oncology provider.

“Despite the number of medical care and public health organizations supporting strong restrictions designed to prevent skin cancer, the magnitude of the problem remains alarming,” Alberg says. “While these groups have led important efforts in the areas of indoor tanning regulations, the promotion of sun protection, and skin cancer prevention research – all of which the American Society of Clinical Oncology supports – the Society’s representation of more than 45,000 cancer care providers gives it a unique perspective on the active role that these oncology professionals can play in the fight against skin cancer.”

The authors’ sun-protection promotion strategies call for policies that allow students to apply sunscreen in schools without physician authorization, improved sunscreen products, education to prevent intentional exposure to increase vitamin D, more shade structures and other infrastructure improvements, and promotion of acceptance for untanned skin. To increase community outreach and education, the statement suggests investing in research to identify effective interventions/best practices and the development of evidence-based approaches for public health programs.

For oncology providers, whose current and potential roles as healthcare professionals are critical to the success of skin cancer prevention and treatment, the statement serves as a call to action. Specifically, the authors recommend discussing skin cancer prevention with patients as part of survivorship care planning, educating patients with cancer regarding their potential increased risk of secondary skin cancers, discussing with patients the importance of sunscreen and protective clothing as well as the dangers of using UVR-emitting indoor tanning devices, advocating for increased legal restrictions on indoor tanning, and supporting primary care and other community providers in their skin cancer prevention strategies.

The statement’s recommendations related to indoor tanning devices include strengthening laws and regulations, implementing age restrictions, posting Surgeon General’s warnings, restricting advertising, and increasing education to communicate risks. These recommendations are timely and relevant to South Carolina. The Teen Skin Cancer Prevention Act, which would prohibit use of tanning beds by youth less than 18 years of age, was under active consideration by the SC state legislature prior to the COVID-19 pandemic. 

“The SC Teen Skin Cancer Prevention Act is aligned with the ASCO recommendations and recommendations of other leading medical and public health organizations,” Alberg says. “Preventing our youth from using tanning beds will prevent disease and death, and help control the melanoma epidemic that is taking place in South Carolina.”

American Society of Clinical Oncology (ASCO) is the national organization representing more than 45,000 physicians and other health care professionals specializing in cancer treatment, diagnosis, and prevention. ASCO members are also dedicated to conducting research that leads to improved patient outcomes and are committed to ensuring that evidence-based practices for the prevention, diagnosis, and treatment of cancer are available to all Americans. ASCO supports efforts to reduce the public health burden of skin cancer by advancing evidence-based policy and practice.


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