by Katie Baker
ETSU College of Public Health
My internship with the Tennessee Cancer Coalition (TC2) is going very, very well! I have made significant progress on the skin cancer prevention toolkit through consultation with experts in the TC2 – Jackson region, the TC2 Skin Cancer Resource Committee Chair from Knoxville, and one of my local supervisors who represents the American Cancer Society. I will be contacting a melanoma survivor from Appalachia as well as a local high school health educator in the coming days in an effort to incorporate their input and experiences into the program as well. Additionally, we will be adding another sun safety awareness event to our schedule. On July 16th, we will provide no-cost educational materials and sun protection aids (i.e., visors, SPF 15 sunscreen, etc.) to those participating in health screenings during the Johnson City Farmers’ Market.
TC2 Summit on Cancer in Tennessee
June 16th & 17th, 2011
As a part of my internship experience, I was invited to attend TC2’s 2011 Summit on Cancer in Tennessee which brought together researchers and academicians, physicians, nurses and other allied health professionals, cancer registrars, employers, health education and outreach professionals, community organizations, legislators, patient navigators, grassroots advocates and volunteers, and cancer survivors to focus on transforming the latest knowledge into strategies that communities, institutions, businesses, and individuals can employ to reduce the cancer burden in our state.
I attended several interesting sessions, which I will describe below, and I even won first place in the Student Poster Competition for my poster titled, “Skin Cancer Prevention in Young Women: Evaluating a Measure of Pathological Tanning.” The poster highlighted the prevalence of indoor tanning dependence and abuse among a sample of college undergraduates as determined by the Structured Interview for Tanning Abuse and Dependence (SITAD).
Pre-Conference Melanoma Workshop
When reviewing the Summit program, I was thrilled to see a pre-conference workshop on skin cancer. During this session, we heard from Tara Bankes, a pathology assistant with Knoxville Dermatopathology Laboratory (KDL), Dr. Roy King, a dermatologist with KDL, and Richard Boland, a melanoma survivor.
From Tara, I learned that 90% of skin cancer cases are caused by UV radiation and that 1 in 5 people (1 in 3 Caucasians) will be diagnosed with some form of skin cancer during their lives. She also pointed out that melanoma, the deadliest form of skin cancer, is most common among 25- to 29-year-old females. She took us through the ABCDs of melanoma detection, which stand for: Asymmetry, Border Irregularity, Color, and Diameter, adding an E to the acronym, which stands for Evolving. Dermatologists believe the “evolution” of moles may be the most tell-tale sign of melanoma development and tell patients to pay particular attention to any changes in size, shape, color, elevation, bleeding, itching or crusting. Tara stressed the importance of skin cancer prevention with the message to COVER UP YOUR SKIN with SPF 30 sunscreen and lip balm, hats, sunglasses, and umbrellas and to limit sun exposure between the hours of 10:00 AM and 4:00 PM. She also emphasized that sufficient levels of Vitamin D can be acquired by spending just 15 minutes in the midday sun, and that sunless tanning products (i.e., spray-on tanning, self-applied lotions and creams) are the way to go for people desiring a tan.
Dr. King shared his work on the development of a melanoma database for Knox County. He and his team have compiled over 6,000 cases from the area and have come to several conclusions:
- From 1998-2007, there was an 82% increase in the incidence of invasive melanoma.
- Melanoma incidence is 46.8% higher in 20- to 29-year-old females when compared to males in the same age group (likely attributable to tanning beds).
- There are more tanning facilities per capita in Knox County than in almost any other city in the country, and the prevalence of tanning among middle schoolers there is 15%.
HPV Vaccination in Appalachia
I also attended a session during which two ETSU professors presented their work on HPV Vaccination in Appalachia. Dr. Sadie Hutson of the ETSU College of Nursing and Dr. Kelly Dorgan of ETSU’s Department of Communications reported on their study in a presentation titled, “Beliefs and Knowledge of HPV and Cervical Cancer in Appalachia.” Here, I learned that Appalachian women face an excessive cancer mortality risk and that 18- to 24-year-olds in this region are surprisingly unaware of HPV. Drs. Hutson and Dorgan conducted interviews and focus groups in Northeast Tennessee and Southwest Virginia and came to the following conclusions:
- Appalachian women face an HPV Vaccination Protection Dilemma, where they perceive two types of “threats”: 1) unknown side effects that potentially outweigh the benefits of avoiding cancer; and 2) non-vaccination and the acquisition of cervical cancer.
- Limited knowledge, skepticism with regard to HPV vaccine commercials, and confusing risk all interplay to keep Appalachian women locked in the protection dilemma.
- Appalachian women often operate in “spheres of silence,” meaning that HPV and the HPV vaccine are not discussed by (1) providers and/or (2) the community.