1. Katalin Fehér 1, Beatrix Oroszi 1, Judit Paller 1, István Ember 2, Maria Cecilia Cercato 3 Skin cancer prevention programme among school-age children 1 County Győr-Moson-Sopron, Institute of National Public Health and Medical Officer’s Service Győr, Hungary 2 University of Pécs, Medical Faculty, Medical Public Health Department Pécs, Hungary 3 Regina Elena Cancer Institute – I.F.O. Rome, Italy CEE Chapter Meeting of ISEE 9-11 June 2005

2. Mortality of melanoma malignum in Hungary (SMR, per 100 000 population) Incidence and mortality of melanoma malignum in Europe in 2002 (SIR, SMR per 100 000 population)

3. Risk factors of melanoma malignum phenotypical characteristics red or fair hair freckles and/or nevi blue, green, grey eyes fair skin environmental factors natural UV-exposure, sunburns artificial UV-exposure genetic factors positive familiar anamnesis xeroderma pigmentosum disorders of the immune system: AIDS, immunsupressive drugs, transplantation

4. Methods of prevention wearing clothes and hats to protect skin, wearing sun glasses to protect eyes using protective body and face cream avoiding excessive use of solarium and sun-lamp teaching „sun-safe” behaviour to children Primary prevention regular self-examination dermatological screening Secondary prevention

5. 1. Questionnaires are distributed to survey the known phenotypical, environmental and behavioural risk factors in primary schools. 3. We send a specific standard letter containing advise on the behaviour to minimise the harmful effects of sun exposure to each child. 2. Evaluation is processed in Rome. The result of the processing is a list of the children’s names specifying school, class and the calculated sun-burn risk (high, medium, low). The programme 2000 questionnaires were distributed in 9 primary schools in Győr city among 6-10 year old children. 1330 (66,5%) evaluable questionnaires were collected. It is focused on the primary prevention of melanoma malignum, among 6-10 year old children.

7. Phenotypical characteristic 1. (0,2%) (0,5%) (1%) 9,5% 32% 51%

8. Have you freckles? To which of these pictures are you alike? 73.2% 13.9% 11.8% 0.9% 0.2% 0.2% Phenotypical characteristic 2. Count the number of „ moles or nevi” you have on your left arm (from elbow to the wrist)

9. 1. using protective body and face cream 2. wearing t-shirt 3. wearing hat Sun protection

10. Where do you spend your holidays? UV-exposure

11. Distribution of risk category in Győr city in 2004 Note: within the high risk group a very high risk goup is marked by the italian partner 9,5 % 60,7 % 28,4 % 1,4 %

12. International results Tunisia 2001-2002 (3 625) Bulgary 2000-2001 (2 210) Russia 2001-2003 (1 245) Italy 1997-2003 (161 504) Spain 2000-2004 (7 120) Belgium 1999-2001 (5 430)

13. Conclusions -An organised primary prevention programme could be proceeded based on this survey. Dermatologists and primary health nurses should be involved. The aim is to teach children sun-safe behaviour. -The identified high risk group should be screened by dermatologist with dermatoscope. The state could be recorded digitally. -By carrying out the survey on the same population after 2-3 years we could evaluate the effectiveness of our intervention in changing their habits. - We can compair the results of different regions and countries. - We would like to spread the project in other cities and regions. In 2004 two regions in Hungary has already joined to this programme.

14. Thank you for your attention!