The report was produced in cooperation with Prof. Dr. Peter von den Driesch, Medical Director of the Centre for Dermatology, Phlebology and Allergology at Stuttgart Hospital, Dr. Christian Fleischer and other dermatologists in private practice in the Ludwigsburg district, the Baden-Württemberg Association of Statutory Health Insurance Physicians and the Baden-Württemberg State Health Office.
Due to the corona crisis, we had to stay indoors for a long time. Now the restrictions have been eased and the weather is tempting us outdoors: we can finally be active outside again and enjoy the sun. But enjoying the sun's rays also has its pitfalls. One consequence can be skin cancer. In its first health report, the district council's health department has compiled data on the topic of skin cancer to determine how widespread skin cancer is in our district and how targeted prevention measures should be initiated. "Intensive joint efforts by local authorities, health insurance companies, doctors and all other stakeholders are necessary to ensure that this data is translated into action for the benefit of the people in our district," says District Administrator Dietmar Allgaier.
According to the Baden-Württemberg Health Atlas 2017, the district of Ludwigsburg was in the top fifth in Baden-Württemberg with 313.9 hospital cases per 100,000 inhabitants due to diseases of the skin and subcutaneous tissue. As in the state as a whole, the number of cases of "black" and "light" skin cancer is also increasing in the district of Ludwigsburg. These are types of skin cancer that can be caused by the ultraviolet components of the sun's rays. In 2016, over 130 people in the district were diagnosed with melanoma, and 17 people died from it in the previous year. If detected in time, the disease is usually no longer fatal, but surgery, treatment and many years of tumor aftercare are often necessary.
According to billing data from the Association of Statutory Health Insurance Physicians, 8,230 men and 11,984 women aged 35 and over took part in skin cancer screening in the district between the 4th quarter of 2017 and the 3rd quarter of 2018. More people aged 35 and over are taking part in the screening and the screening is more frequently taken up by women. Doctors have surgically removed (skin) lesions in 3,301 men and 2,803 women aged 60 and over. Here, the proportion of men predominates, while almost twice as many women are affected in the 5 to 60 age category.
The six dermatology practices participating in the survey alone reported 643 patients with suspected melanoma and 5,593 with suspected "light skin cancer" in 2018. They carried out skin cancer screenings on around 29 percent of the patients they treated. Fifty percent more women than men took advantage of this recommended screening.
In Germany, more than 290,600 people are newly diagnosed with skin cancer every year, of which around 36,400 are diagnosed with the more dangerous "black skin cancer" (malignant melanoma). The average age of onset for malignant melanoma is 67 years for men and 59 years for women. However, even children and adolescents develop skin cancer.
Appropriate exposure to the sun's rays and regular skin checks for suspicious changes can protect against a fatal disease or this form of suffering. Attention should be paid to both recreational behavior and protection when working outdoors. In 2016, 3,887 cases of certain forms of "light" skin cancer (squamous cell carcinoma or multiple actinic keratoses) were recognized as an occupational disease nationwide. In Baden-Württemberg alone, there were 396 cases.
Tips for prevention:
- Avoid intense sun
- Pay attention to the UV index. This indicates the intensity of UV radiation on a daily basis: www.bfs.de/uv-prognose
- Spend lunchtime indoors or in the shade
- Cover your skin with clothing, wear a hat
- Protect your eyes with sunglasses. Pay attention to DIN EN ISO 12312-1 and UV-400 labeling
- Use sun cream for uncovered areas of skin. Sun protection factor 30 (high), UVA and UVB protection
- Technical protective measures, such as awnings, pergolas and shade-providing greenery
- Organizational protective measures:
o Provision of UV protective clothing for outdoor employees.
o Shifting activities to the morning and evening hours. Adapt working hours, break arrangements and timetables to UV intensity
o Taking the UV index into account when planning outdoor activities
