Introduction

Managing patients with skin conditions in primary care will undoubtedly include skin cancer prevention. Prevention is an important aspect of the nurses role and involves three levels of intervention.

1. Education and self-care.

2. Screening for early disease with appropriate referral.

3. Specialist management and psychological intervention for patients with skin cancer.

This chapter aims to review skin cancer as a disease entity. Interventions which focus on health promotion through education and disease prevention strategies are highlighted.

Epidemiology of skin cancer

The incidence of skin cancer continues to rise within the white European adult population (Diepgen & Mahler 2002; De Gruijl 1999; WHO 1994). There are two main groups of skin cancer, melanoma skin cancer and non-melanoma skin cancer. Malignant melanoma is the least common but most lethal form of skin cancer with approximately 6000 new cases being diagnosed each year. Unfortunately the mortality rate for melanoma is high due to delayed diagnosis and intervention. Latest mortality figures indicate 2500 deaths per year from this disease (National Radiological Protection Board 2002; Office of National Statistics (ONS) 2000).

Non-melanoma skin cancers (basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)) are more common with more than 46,000 new cases diagnosed each year. BCC rarely metastasise but can be disfiguring. SCC can metastasise and accounts for approximately 400 deaths per year in the UK (National Radiological Protection Board 2002).