Skin cancer is the most commonly diagnosed cancer in the United States, yet most cases are preventable. Every year in the United States, nearly 5 million people are treated for skin cancer, at an estimated cost of $8.1 billion. Melanoma, the most deadly form of skin cancer, causes nearly 9,000 deaths each year. Despite recent efforts to address risk factors, skin cancer rates continue to rise. While those with lighter skin are more susceptible, anyone can get skin cancer—and it can be serious, even deadly. Almost all of the conditions can be caused by unnecessary ultraviolet (UV) radiation exposure, usually from excessive time in the sun or from the use of indoor tanning devices. It is alarming that every year, nearly one out of every three young white women aged 16–25 engages in indoor tanning. It's important to shatter the myth that tanned skin is a sign of health. And a “base” tan is not a “safe” tan. Tanned skin is damaged skin. Understanding the risk of UV exposure is crucial to protecting ourselves and our loved ones. That is why “The Surgeon General's Call to Action to Prevent Skin Cancer” is important for all of us. It outlines action steps we can all take—as individuals, parents, educators, employers, policy makers, health care professionals, and communities—to reverse this alarming trend. As a nation, we can all do more to address skin cancer as a serious public health challenge. Everyone is urged to find out more about the risk of skin cancer—and what we all can do to prevent it.

Human skin cancers, the most common type of tumors, represent a significant health burden. The deadliest is unquestionably melanoma. Half of melanomas have an activating mutation in the BRAF gene, prompting development of novel drugs, vemurafenib and dabrafenib, specifically targeting mutated BRAF. Trametinib and cobimetinib, which block MEK, a BRAF effector protein, have been used in combination with BRAF inhibitors. A promising new melanoma treatment is immunotherapy, approach that boosts patient's own immune system to attack cancer. Pembrolizumab and nivolumab inhibit PD-1, whereas Ipilimumab targets CTLA-4, another immunity check point, to boost the immune response. Here we focus on pathways, mechanisms, targets and treatments of human skin cancers, with particular emphasis on the new developments in the research on melanomas.

Mohs Micrographic Surgery, an advanced treatment procedure for skin cancer, offers the highest potential for recovery--even if the skin cancer has been previously treated. This procedure is a state-of-the-art treatment in which the physician serves as surgeon, pathologist, and reconstructive surgeon. It relies on the accuracy of a microscope to trace and ensure removal of skin cancer down to its roots. This procedure allows dermatologists trained in Mohs Surgery to see beyond the visible disease and to precisely identify and remove the entire tumor, leaving healthy tissue unharmed. This procedure is most often used in treating two of the most common forms of skin cancer: basal cell carcinoma and squamous cell carcinoma. The cure rate for Mohs Micrographic Surgery is the highest of all treatments for skin cancer--up to 99 percent even if other forms of treatment have failed. This procedure, the most exact and precise method of tumor removal, minimizes the chance of regrowth and lessens the potential for scarring or disfigurement

The third edition is a comprehensive and updated overview of positive and negative effects of UV-exposure, with a focus on Vitamin D and skin cancer. Researchers, oncologists,and students will be provided with the most significant and timely information related to topics such as the epidemiology of skin cancer, the immune system and skin cancer, ultraviolet damage, DNA repair and Vitamin D in Nonmelanoma skin cancer and malignant melanoma. There have been a number of new, scientific findings in this fast moving field that necessitated a thoroughly updated and revised edition including new Vitamin D metabolites and skin cancer, new findings on the beneficial effects of UV and solar UV and skin cancer, adverse effects of sun protection and sunscreens, sun exposure and mortality, and more. The book will summarize essential, up-to-date information for every clinician or scientist interested in how to balance the positive and negative effects of UV‐exposure to minimize the risks of developing vitamin D deficiency and skin cancer.

This report, which was developed by an expert committee of the Institute of Medicine, reviews the first three services listed above. It is intended to assist policymakers by providing syntheses of the best evidence available about the effectiveness of these services and by estimating the cost to Medicare of covering them. For each service or condition examined, the committee commissioned a review of the scientific literature that was presented and discussed at a public workshop. As requested by Congress, this report includes explicit estimates only of costs to Medicare, not costs to beneficiaries, their families, or others. It also does not include cost-effectiveness analyses. That is, the extent of the benefits relative to the costs to Medicareâ€"or to society generallyâ€"is not evaluated for the services examined. The method for estimating Medicare costs follows the generic estimation practices of the Congressional Budget Office (CBO). The objective was to provide Congress with estimates that were based on familiar procedures and could be compared readily with earlier and later CBO estimates. For each condition or service, the estimates are intended to suggest the order of magnitude of the costs to Medicare of extending coverage, but the estimates could be considerably higher or lower than what Medicare might actually spend were coverage policies changed. The estimates cover the five-year period 2000-2004. In addition to the conclusions about specific coverage issues, the report examines some broader concerns about the processes for making coverage decisions and about the research and organizational infrastructure for these decisions. It also briefly examines the limits of coverage as a means of improving health services and outcomes and the limits of evidence as a means of resolving policy and ethical questions.

Our series Cancer Prevention - Cancer Control continues to address the causes and prevention of cancer. In this volume, Hill, Elwood, and English bring together a rich resource summarizing the state of science underpinning the primary prevention of skin cancer. While skin cancer causes an increasing burden, particularly in populations of European origin, our understanding of the role of sun exposure together with the genetic components of skin cancer continues to grow. Given the emphasis on evidence-based medicine and public health prevention efforts, it is noteworthy that, although we can all access the same evidence base, countries around the world have had remarkably different responses to the application of this knowledge to prevent skin cancer. The outstanding contribution of the Australian public health community to the scientific understanding of skin cancer etiology and the translation of this knowledge into national prevention efforts uniquely positions the editors to compile this volume focused on the primary prevention of skin cancer. In so doing they draw on an international team of authors to present a “state of the science” summary of skin cancer prevention and to identify those areas where uncertainty remains. To achieve successful prevention of cancer we must translate our scientific knowledge base into effective prevention programs. This book offers the reader keen insights into the depth of our understanding of etiologic pathways for skin cancer. This etiologic science base is complemented by rigorous prevention science placing emphasis on the social context for effective and sustained prevention efforts.