Recommendations of the European Society of Skin Prevention (EUROSKIN)

1. EUROCHIP-2 – Prevention domain Group of specialist Basel, 10th-11th November 2005 Recommendations of the European Society of Skin Prevention (EUROSKIN) Source:Greinert et al. Eur J Cancer Prevention (2001)

2. Age-Standardized incidence rate for melanoma. Males * European Standard Population *100.000 Source: EUCAN database: 1998 estimates, version 5.0; OECD Health Data 2004.

3. Age-Standardized incidence rate for melanoma. Females * European Standard Population *100.000 Source: EUCAN database: 1998 estimates, version 5.0; OECD Health Data 2004.

4. Age-Standardized mortality rate for melanoma. Males * European Standard Population *100.000 Source: EPICANCER

5. Age-Standardized mortality rate for melanoma. Females * European Standard Population *100.000 Source: EPICANCER

6. RECOMMENDATIONS ON • Experimental biological research • Epidemiology • Primary prevention • UVR monitoring and exposure assessment • Evaluation of primary prevention • Secondary prevention • Public relations • Media coverage • Collaboration • Marketing • UVR tanning devices Source: Greinert et al. Eur J Cancer Prevention (2001)

7. PRIMARY PREVENTION • explore ways to communicate risk about environmental change and behaviour • recognize and include exposure from artificial sources • provide uniformity of messages with regard to risk • support education and awareness of exposure • encourage development of educational material • encourage coordination of protection programmes • seek the cooperation of the travel industry, other commercial outlets and the news media • convince decision-makers that campaigns of primary prevention will be effective, will save lives and will be economically sound • focus attention on protection of children Source: Greinert et al. Eur J Cancer Prevention (2001)

8. SECONDARY PREVENTION • It is necessary investigation on • burden of the various skin cancers • cost-effective methods • definition of different outcome measures • balance between favourable and unfavourable effects • accuracy of total skin inspection as a screening tool by various examiners • standardization of histopathological terminology and definitions of skin cancer lesions • organizational models compatible with the various health care systems in the European countries Source: Greinert et al. Eur J Cancer Prevention (2001)

9. UVR TANNING DEVICES • General statement: the use of tanning devices for cosmetic purposes is not recommended • People should not use tanning devices if they: • have type I skin • are less than 18 years of age • have large numbers of naevi moles • tend to freckle • have a history of frequent childhood sunburn • have premalignant or malignant skin lesions • have sun damaged skin • are wearing cosmetics these may enhance their sensitivity to UV exposure • are taking medications that will make them UV-sensitive Source: Greinert et al. Eur J Cancer Prevention (2001)

10. IARC RECOMMENDATIONS ON SUNSCREENS • Protection of the skin: • wearing tightly protective clothing (arms, trunk and legs) • wearing a hat (head) • avoiding outdoor activities during periods of peak insolation • use of sunscreens • Sunscreens should not be the first choice for skin cancer prevention • Daily use of a sunscreen with a high SPF (15 or over) on usually exposed skin in areas of high insolation • Adequate solar protection is more important during childhood than at any other time in life • Sunscreens should be subject to the same regulatory safety requirements as medicines Source: IARC Handbooks of Cancer Prevention n°5

11. DISCUSSIONS • Compare advertising/regulations UVR tanning devices in EU countries • Monitor the use of EUROSKIN recommendations • Awareness of pediatricians all over the EU • Counseling with parents • To use the UV Index: to expand the use (educational tool) • Advertising in swimming pool • Montreal protocol aims to the reduction of the ozone gap • Non melanoma skin cancers: we do not know a lot • UICC Prevention book