That was the core message that came out of the introduction this morning of the Surgeon General’s Call to Action to Prevent Skin Cancer at a meeting held at the National Press Club in Washington DC.
There were some other messages that now raise skin cancer awareness and prevention high on the public health awareness list, such as the fact that over 5 million people every year have a diagnosis of skin cancer (and many have more than one skin cancer), and that we are spending over $8 billion dollars treating the disease. But most important is the fact that this is one of the most preventable cancers, and if current trends are any indication we are not getting the job done when it comes to decreasing the number of skin cancers and saving lives.
Acting Surgeon General Boris Lushniak MD and Undersecretary of Health Howard Koh MD were masterful presenting the evidence contained in the report, and American Cancer Society Cancer Action Network volunteer Stacey Escalante — who herself is a melanoma survivor and media personality from Las Vegas — made the story personal.
And it is personal. It is particularly personal for me as a skin cancer survivor, and it is personal for millions of people throughout this nation and throughout the world. The real question remains, however, given the fact that skin cancer is so common and has impacted so many, why aren’t we doing more to prevent it? Hopefully this report will bring that conversation to a new level and lead to more and better public health interventions.
The reality is that in years past we didn’t know what we could do to reduce the threat of skin cancer. That wasn’t always the case. People like me who grew up decades ago didn’t know about the risk of sun exposure, tans and sunburns. We didn’t use sunscreens because we didn’t have them. We thought tan was a sign of health, not a sign of damage as was repeated several times today during the presentations. We simply didn’t know.
Now we know.
We know what to do to prevent many (not all) skin cancers and skin aging. We know to avoid the sun at peak times of the day. We know to wear wide brimmed hats and use UV certified protective sun glasses. We know to use plenty of sunscreen that is broad spectrum (limiting the absorption of the harmful ultraviolet A and B rays from the sun). We know to reapply sunscreen again and again when swimming and/or sweating. We know to wear sun protective fabrics and seek the shade when outdoors. We know tanning beds are bad for us (but their use is everywhere, especially by young white women. By the way, they have been linked to 245,000 basal cell cancers, 168,000 squamous cell cancers and 6000 melanomas every year in the United States according to the report). We know that we can get vitamin D safely from supplements instead of overexposure to the sun. And every year 1/3 of American adults get a sunburn which especially in childhood is a leading risk factor for skin cancer, including melanoma (last year even the self-confessing surgeon general readily admitted he got a sunburn, noting that bad things happen even to people who know better).
Yes, we know what to do but we still really don’t do what we know.
We can do better. We need to develop messaging that resonates with people. We need laws that restrict youth access to tanning beds (lots of progress has been made on that front, but we have a ways to go). We need to see more people engaging in sun safe behaviors, even while engaging in healthy outdoor (and enjoyable) activities.
We need to read and take to heart and mind the goals of the surgeon general’s report and move forward with a coordinated, nationwide public health action plan that makes the lessons real and makes them actionable. Among the goals:
- Increase opportunities for sun protection in outdoor settings.
- Provide individuals with the information they need to make informed, healthy choices about UV exposure.
- Promote policies that advance the national goal of preventing skin cancer.
- Reduce harms from indoor tanning.
- Strengthen research, surveillance, monitoring and evaluation related to skin cancer prevention.
Maybe there is some evidence of hope: This past weekend while at a beach in south Georgia we saw lots of people outside in the sun enjoying themselves. On one day, I counted about three out of four families were actually under what I call “meaningful shade” such as a large canopy tent. It was a lot different than what I have seen before, so maybe we are making some progress after all. But I want (need?) to believe we can do even more to embrace sun safe behaviors.
So the surgeon general has laid out the call to action. But as he noted to the audience and to me personally after the session it is up to us to translate that information into effective education and interventions.
As he pointed out, years ago the message went out “Tobacco bad.” Today, the message is “Ultraviolet bad.” We need to make certain that people understand what that means, and that all of us together do something about it. 5 million people getting a largely preventable and sometimes disfiguring and even fatal cancer every year in the United States is simply not something that we need to endure any longer.
We know what to do. Now is the time to make it happen.