Skin Cancer Prevention PDF

Preface

The increase in the cancer incidence has created a problem worldwide. Skin cancer is an important part of the problem. In countries with a white population there is an increasing incidence of cutaneous malignant melanoma as well as squamous cell and basal cell carcinoma. Skin cancer overall, including both malignant melanoma and nonmelanoma skin cancer, is the most frequent tumor type, resulting in decreased quality of life for patients and relatives as well as increasing health economy costs. In addition to the burden of skin cancer on morbidity, mortality is a consequence of cutaneous malignant melanoma including young individuals.

Prevention is an important strategy for reducing the cancer problem. For skin cancer, risk factors have been identified, making it possible to identify individuals at increased risk and behaviors that decrease both mortality and morbidity. Ultraviolet radiation, both from the sun and artificial ultraviolet sources, is the most important external risk factor for all three types of skin cancer. Over time more information about constitutional risk factors has been generated, among which the genetic background of the familial aggregation of skin cancer will significantly improve the identification of high-risk individuals. Early detection, no doubt, is a powerful tool for the improvement of prognosis for patients with cutaneous malignant melanoma. In this respect, understanding tumor progression and identification of precursor lesions most probably will improve prevention. Thus, both primary prevention and early detection are powerful strategies for decreasing mortality and morbidity as well as increasing the quality of life and cost-effectiveness in the skin cancer area.

The aim of this book is a comprehensive review of skin cancer prevention. Epidemiology gives us information about the extent of the problem and identifies the risk factors for skin cancer (external behavioral and constitutional). An expanding knowledge in the basic research area creates new possibilities for developing more effective prevention strategies. An important question is whether all ultraviolet radiation is harmful, or if lower doses are beneficial. Relationships between knowledge, attitudes and behavior are complex and we need more research in order to establish effective primary prevention aiming at behavioral change. Whether screening strategies are rational for early detection is another question yet to be answered. Communication strategies are crucial when conveying health messages and must be elaborated in different ways depending on the target population. The knowledge of the cost-effectiveness of skin cancer prevention programs is however limited, and must be studied in more detail.

A comprehensive view of skin cancer prevention shows the importance of developing translational research in order to establish evidence-based prevention. We hope this book will stimulate thinking to proceed in this direction.

The book editors are members of the European Society of Skin Cancer Prevention (EUROSKIN), an organization formed in 1999. An important mission for EUROSKIN is to harmonize skin cancer prevention in Europe. So far four international conferences have been arranged with the aim of improving communication among epidemiologists and basic researchers with researchers and actors in prevention programs to establish translational research in this area. The ultimate aim is to develop evidence-based and cost effective skin cancer prevention. We hope that this book will help us to move into this direction.