RESEARCH POSTER PRESENTATION DESIGN © 2012

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• According to the EPA and CDC, the most prevalent diagnosed

cancer in the United States is skin cancer. One in five

Americans will be diagnosed with skin cancer in their lifetime. 3

• The American Cancer Society estimated that 76,690 people

would be diagnosed with melanoma in 2013, of which Florida

represents 5,330 of these new cases, the second highest

population behind California.2

• Nonmelanoma skin cancers (NMSCs) include basal cell

carcinoma and squamous cell carcinoma. These are the most

commonly diagnosed forms of cancer in the United States,

making up 1.3 million cases annually.6

• They are usually diagnosed after the age of 55, and although the

death rates due to NMSCs are low, they represent about 5% of

all Medicare cancer expenditures.6

• Direct sun exposure, blistering sunburns in childhood, and

family history are risk factors for these type of skin cancer.6

• Malignant melanoma is the deadliest form of skin cancer and

can develop from pre-existing moles or on normal skin.

• The risk factors for melanoma include a light complexion, a

large number of moles, blistering sunburns during childhood,

sun exposure, and family history.6

• If caught early, melanoma can be curable, thus it is important to

teach patients to examine their skin and be aware of changing

moles. However, if not caught early, melanoma has a higher risk

of metastasis and high death rates.6

• The most effective way to prevent skin cancer is to use sun-safe

practices and to perform regular skin self-examinations.1

• There is limited public awareness of NMSCs and its prevention,

along with low rates of sun-safe practices, in residents of the

United States.5

• Areas with higher prevalence of NMSCs had greater levels of

awareness and concern about skin cancer and had more skin

cancer screenings.5

• Floridians have higher rates of skin cancer screening compared

to other states.4

• These facts suggest that initiatives towards reducing sun

exposure in areas where sun exposure is more frequent may be

effective in reducing the rates of skin cancer.

INTRODUCTION

OBJECTIVES

• Participants were recruited from the waiting room of the internal

medicine and geriatric section of the Ziff Clinic at Nova

Southeastern University.

• Inclusion criteria to participate in the study were 40 years of age

or older, male or female, all races, English speaking, and those

who could give voluntary consent.

• Forty-seven patients were willing to participate and were then

given a consent form and survey.

• The participants were also given educational literature issued by

the American Academy of Dermatology, as seen below.

• The survey consisted of 18 questions—15 yes or no questions,

two multiple-choice questions, and one open-ended question.

• Ten of the yes or no questions included a follow-up question,

with five yes or no questions, one multiple-choice question, and

four fill-in-the-blank questions.

• The questions determined education about skin cancer, skin

cancer screening habits, skin cancer treatment options, sun-safe

practices, and beliefs about skin cancer and sun exposure.

• Data was then analyzed using Excel software to determine

averages and percentages for each question on the survey.

METHODSGender Age

• Have you ever had a skin cancer screening?

• 56% (n=6) stated that they had a skin cancer screening in the last 12 months. 9% (n=4) had

been told that they were at an increased risk of developing skin cancer. Only 32% (n=15)

stated that they performed skin self-exams at home regularly. Of those, 47% (n=7) stated

that they had been taught what to look for, which is the ABCDEs of suspicious moles.

85% (n=40) stated that they would seek medical attention for a changing mole. 15% (n=7)

stated that they had a family member with skin cancer, and of these, only two participants

knew what type of skin cancer their family member had.

• Are you aware of the different types of skin cancers?

• Five participants in this group could identify the most dangerous form of skin cancer. 83%

(n=39) reported that they were unaware of the different treatment options for skin cancers.

79% (n=37) reported that they avoided the sun between 10:00am and 4:00pm.

• Do you use sun protection?

• The majority of the participants who did report using sunscreen stated that they applied it

to their face, neck, and arms when outside in direct sunlight for long periods of time. 55%

(n=26) stated that they did not know that it’s recommended to apply one oz. of broad

spectrum (UVA/UVB), at least SPF 15 sunscreen 30 minutes before sun exposure and to

reapply every two hours. 66% (n=31) reported that they had been sunburned in their

lifetime; however, 68% (n=21) of this group had not had a sunburn in the last 12 months.

Also, 94% (n=44) reported never using a tanning bed, and the three participants who had

used a tanning bed reported not using one in the previous 12 months.

• Do you feel it is important to protect yourself from sun exposure on a

regular basis?

• Do you believe there is a lack of knowledge and information available to

aid the population in making sun-safe decisions?

• 74% of participants (n=35) stated that they would have avoided the sun in their youth if

they had known then what they know now about skin cancer and sun damage.

RESULTS DISCUSSION

• The majority of participants had not had a skin cancer screening,

nor had they had a physician discuss skin cancer with them.

They were not performing skin self-examinations at home but

would seek medical attention for a changing mole. These

outcomes imply that there may be a lack of emphasis on the

importance of skin cancer screening among primary care

physicians (PCPs).

• PCPs should be encouraged to discuss skin cancer prevention

and diagnosis with their patients and to provide their patients

with literature concerning this common, and potentially deadly,

disease.

• PCPs should be encouraged to pursue continuing education

regarding dermatological diseases in order to better recognize

when to refer their patients to a dermatologist.

• PCPs should instruct their patients on how to properly perform a

self-examination, how to identify suspicious moles, and

encourage them to use sunscreen and sun protection every day,

regardless of their time in direct sunlight.

• For the 47% of participants who do not protect themselves

properly when exposed to the sun, they may be difficult to

motivate since sun damage can take decades to appear and is not

often viewed as an imminent problem. Most skin cancers are

only skin deep, with rarely associated symptoms or internal

manifestations, so patients may not take it seriously.

• Skin cancer is the most common form of cancer in the United

States, and malignant melanoma is responsible for one death

every hour.7

• Skin cancer educational efforts through the media are the most

prominent form of raising awareness, thus information regarding

skin cancer prevention, detection, and treatment should continue

to be distributed by the media.5 However, behavioral change is

not shown over the long term, necessitating implementation of

more patient education from PCPs.

• There are several public health initiatives working to raise skin

cancer awareness. Skin cancer costs billions of dollars a year to

treat.7 These initiatives are critical to public health and will

hopefully, in the long run, help to save lives and to lower the

yearly cost created by skin cancer in the United States.

• It is imperative that PCPs talk with their patients about skin

cancer, and that people are educated through media and public

initiatives about the facts concerning skin cancer, performing

skin self-examinations, and implementing sun-safe practices into

their daily lives.

1. American Academy of Dermatology. (2014). Diseases and treatments. Retrieved from http:/

www.aad.org/dermatology-a-to-z/diseases-and-treatments

2. American Cancer Society. (2013). Cancer facts and figures. Atlanta, GA: American Cancer Society.

Retrieved from http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/

document/acspc-036845.pdf

3. Environmental Protection Agency & Center for Disease Control. (2010). Facts about: Skin cancer.

Retrieved from http://www2.epa.gov/sites/production/files/documents/fl_facts_web.pdf

4. Fernandez, C.A., McClure, L.A., LeBlanc, W.G., Clarke, T.C., Kirsner, R.S., Arheart, K.L., & Lee,

D.J. (2012). A comparison of Florida skin cancer screening rates with those in the rest of the United

States. Archives of Dermatology, 148 (3), 393-395.

5. Halpern, A.C. & Kopp, L.J. (2005). Awareness, knowledge and attitudes to non-melanoma skin

cancer and actinic keratosis among the general public. International Journal of Dermatology, 44,

107-111.

6. James, W.D., Berger, T.G., & Elston, D.M. (2011). Andrews’ diseases of the skin: Clinical

dermatology (11th ed.). London, UK: Saunders Elsevier.

7. Skin Cancer Foundation. (2014). Skin cancer facts. Retrieved from http://www.skincancer.org/skin-

cancer-information/skin-cancer-facts

REFERENCES

• Evaluate sun safe practices and skin cancer awareness

• Evaluate reasons for a lack of public education

• Recommend how to enhance public education

• Educate the study participants by providing them with

educational materials

Nova Southeastern University, Broward Health Medical Center

Sasha M. Chediak, DO, MPH, MBS

Skin Cancer Awareness, Prevention, and Education in Adults Over Age 40

34%

64%

2%

MALE n=16

FEMALE n=30

NA n=1

26%

19%15%

21%

11%2% 6%

40-50 n=12

51-60 n=9

61-70 n=7

71-80 n=10

81-90 n=5

91+ n=1

NA n=3

23%

77%

YES n=11

NO n=36

10

37

0

5

10

15

20

25

30

35

40

Yes or No

Yes

No

33

11

0

5

10

15

20

25

30

35

Yes or No

Yes

No

2522

0

5

10

15

20

25

30

Yes or No

Yes

No

42

5

0

5

10

15

20

25

30

35

40

45

Yes or No

Yes

No