Kritin K. Verma, BS, MBA

Compared to later-onset procedures, early diagnosis of melanoma using affordable skin biopsies can result in better patient outcomes, lower health care expenditures, and enhanced psychological well-being.¹ Numerous research and economic evaluations that highlight the possible advantages of early intervention in melanoma care lend support to this strategy. In health care systems, the cost of early identification and screening for skin cancer is a critical factor.¹ There has been debate in the literature regarding performing more frequent biopsies earlier for skin cancers, which may greatly improve patient outcomes at the expense of increased financial cost, compared with performing fewer biopsies, which reduces costs at the potential expense of managing later-onset melanoma.^1,2 We sought to summarize the current literature and address some considerations that may help bring more clarity to this topic.

According to a study of a large health care system, the average cost of a skin cancer screening visit was $150, of which $105 (70%) went toward the costs of the office visit and $45 (30%) went toward the costs of the biopsy.¹ In the changing health care landscape, it is crucial to take into account the possible compounded savings from early diagnosis and treatment. While biopsies do involve some expenses, consideration of immunotherapy costs for advanced melanoma also should be considered, as they provide an alternative viewpoint on the financial effects of melanoma treatment.² The use of new systemic treatments such as immunotherapy has led to a notable rise in Medicare users’ first-year melanoma treatment expenses. The average expense of treating stage IV melanoma rose from $47,739 in 2007 through 2012 to $117,450 in 2018 through 2019. This sharp rise highlights how much more expensive treating advanced melanoma is than performing biopsies for early detection and treatment. Hundreds of biopsies might be carried out for the cost of a single advanced melanoma therapy, possibly identifying several cases at an earlier, more manageable stage.²

Patient quality of life and survival rates also can be considerably improved by early melanoma detection through screening.³ Compared to patients with later-stage diagnoses, those with early-stage melanoma reported a higher overall quality of life. Better physical functioning and reduced levels of anxiety and sadness were linked to early identification using skin biopsies. Patients with more advanced melanoma who had later-onset procedures, on the other hand, experience worsening psychological symptoms and physical health.³

A cost-effectiveness analysis using a Markov cohort model compared the long-term economic impact of early detection and primary prevention of melanoma. It found that daily use of sunscreen could prevent a substantial number of new skin tumors and melanoma deaths and reduce health care costs when compared to early detection strategies such as performing extra biopsies.⁴ There already are programs across the United States that aim to educate the public on the importance of wearing sunscreen; this has, in turn, reduced the prevalence of skin cancer in certain communities. Primary prevention resulted in just 1364 new melanomas and more than $430 million in expenditures per 100,000 individuals, whereas early diagnosis produced 2446 new melanomas and more than $660 million in economic expenses per 100,000 individuals.⁴ It is imperative to acknowledge that skin biopsies remain a vital tool for the early identification of melanoma, particularly in high-risk groups.

By using technologies such as teledermoscopy, the cost-effectiveness of skin cancer referral and consultation can be further enhanced; for example, teledermoscopy for skin cancer referral and triage would result in faster clinical resolution at an average cost of $54.64 per case. This method may reduce the need for redundant in-person consultations and increase the effectiveness of melanoma identification.⁵

Large-scale public health initiatives in skin cancer prevention and early detection have the potential to be very effective, as evidenced by the War on Melanoma project at Oregon Health & Science University (Portland, Oregon). This all-encompassing strategy, which uses cutting-edge technologies, public education, and health care professional training, has improved melanoma outcomes and decreased health care expenditures with encouraging results.⁶

A few tactics can be used to best balance the costs of later-onset procedures and early skin biopsies. These include using advanced technologies such as teledermoscopy and dermoscopy, provider training to increase diagnostic accuracy, public health campaigns to raise awareness and promote prevention, and a comprehensive strategy combining targeted early detection strategies with primary prevention.^5,6 Health care systems can optimize the financial efficiency and clinical results of melanoma treatment by putting these principles into practice.

Compared to later-onset melanoma procedures, early skin biopsies typically are more cost-effective, produce better patient outcomes, and offer psychological advantages, even if they may have a higher initial cost. Health care systems can optimize the trade-off between early detection and cost effectiveness in melanoma management by putting sophisticated technology to use, enhancing provider training, and implementing focused screening programs.^5,6 To support evidence-based policies and guidelines, future research should assess the long-term economic impact of different melanoma prevention and detection measures.

Compared to later-onset procedures, early diagnosis of melanoma using affordable skin biopsies can result in better patient outcomes, lower health care expenditures, and enhanced psychological well-being.¹ Numerous research and economic evaluations that highlight the possible advantages of early intervention in melanoma care lend support to this strategy. In health care systems, the cost of early identification and screening for skin cancer is a critical factor.¹ There has been debate in the literature regarding performing more frequent biopsies earlier for skin cancers, which may greatly improve patient outcomes at the expense of increased financial cost, compared with performing fewer biopsies, which reduces costs at the potential expense of managing later-onset melanoma.^1,2 We sought to summarize the current literature and address some considerations that may help bring more clarity to this topic.

According to a study of a large health care system, the average cost of a skin cancer screening visit was $150, of which $105 (70%) went toward the costs of the office visit and $45 (30%) went toward the costs of the biopsy.¹ In the changing health care landscape, it is crucial to take into account the possible compounded savings from early diagnosis and treatment. While biopsies do involve some expenses, consideration of immunotherapy costs for advanced melanoma also should be considered, as they provide an alternative viewpoint on the financial effects of melanoma treatment.² The use of new systemic treatments such as immunotherapy has led to a notable rise in Medicare users’ first-year melanoma treatment expenses. The average expense of treating stage IV melanoma rose from $47,739 in 2007 through 2012 to $117,450 in 2018 through 2019. This sharp rise highlights how much more expensive treating advanced melanoma is than performing biopsies for early detection and treatment. Hundreds of biopsies might be carried out for the cost of a single advanced melanoma therapy, possibly identifying several cases at an earlier, more manageable stage.²

Patient quality of life and survival rates also can be considerably improved by early melanoma detection through screening.³ Compared to patients with later-stage diagnoses, those with early-stage melanoma reported a higher overall quality of life. Better physical functioning and reduced levels of anxiety and sadness were linked to early identification using skin biopsies. Patients with more advanced melanoma who had later-onset procedures, on the other hand, experience worsening psychological symptoms and physical health.³

A cost-effectiveness analysis using a Markov cohort model compared the long-term economic impact of early detection and primary prevention of melanoma. It found that daily use of sunscreen could prevent a substantial number of new skin tumors and melanoma deaths and reduce health care costs when compared to early detection strategies such as performing extra biopsies.⁴ There already are programs across the United States that aim to educate the public on the importance of wearing sunscreen; this has, in turn, reduced the prevalence of skin cancer in certain communities. Primary prevention resulted in just 1364 new melanomas and more than $430 million in expenditures per 100,000 individuals, whereas early diagnosis produced 2446 new melanomas and more than $660 million in economic expenses per 100,000 individuals.⁴ It is imperative to acknowledge that skin biopsies remain a vital tool for the early identification of melanoma, particularly in high-risk groups.

By using technologies such as teledermoscopy, the cost-effectiveness of skin cancer referral and consultation can be further enhanced; for example, teledermoscopy for skin cancer referral and triage would result in faster clinical resolution at an average cost of $54.64 per case. This method may reduce the need for redundant in-person consultations and increase the effectiveness of melanoma identification.⁵

Large-scale public health initiatives in skin cancer prevention and early detection have the potential to be very effective, as evidenced by the War on Melanoma project at Oregon Health & Science University (Portland, Oregon). This all-encompassing strategy, which uses cutting-edge technologies, public education, and health care professional training, has improved melanoma outcomes and decreased health care expenditures with encouraging results.⁶

A few tactics can be used to best balance the costs of later-onset procedures and early skin biopsies. These include using advanced technologies such as teledermoscopy and dermoscopy, provider training to increase diagnostic accuracy, public health campaigns to raise awareness and promote prevention, and a comprehensive strategy combining targeted early detection strategies with primary prevention.^5,6 Health care systems can optimize the financial efficiency and clinical results of melanoma treatment by putting these principles into practice.

Compared to later-onset melanoma procedures, early skin biopsies typically are more cost-effective, produce better patient outcomes, and offer psychological advantages, even if they may have a higher initial cost. Health care systems can optimize the trade-off between early detection and cost effectiveness in melanoma management by putting sophisticated technology to use, enhancing provider training, and implementing focused screening programs.^5,6 To support evidence-based policies and guidelines, future research should assess the long-term economic impact of different melanoma prevention and detection measures.

Compared to later-onset procedures, early diagnosis of melanoma using affordable skin biopsies can result in better patient outcomes, lower health care expenditures, and enhanced psychological well-being.¹ Numerous research and economic evaluations that highlight the possible advantages of early intervention in melanoma care lend support to this strategy. In health care systems, the cost of early identification and screening for skin cancer is a critical factor.¹ There has been debate in the literature regarding performing more frequent biopsies earlier for skin cancers, which may greatly improve patient outcomes at the expense of increased financial cost, compared with performing fewer biopsies, which reduces costs at the potential expense of managing later-onset melanoma.^1,2 We sought to summarize the current literature and address some considerations that may help bring more clarity to this topic.

According to a study of a large health care system, the average cost of a skin cancer screening visit was $150, of which $105 (70%) went toward the costs of the office visit and $45 (30%) went toward the costs of the biopsy.¹ In the changing health care landscape, it is crucial to take into account the possible compounded savings from early diagnosis and treatment. While biopsies do involve some expenses, consideration of immunotherapy costs for advanced melanoma also should be considered, as they provide an alternative viewpoint on the financial effects of melanoma treatment.² The use of new systemic treatments such as immunotherapy has led to a notable rise in Medicare users’ first-year melanoma treatment expenses. The average expense of treating stage IV melanoma rose from $47,739 in 2007 through 2012 to $117,450 in 2018 through 2019. This sharp rise highlights how much more expensive treating advanced melanoma is than performing biopsies for early detection and treatment. Hundreds of biopsies might be carried out for the cost of a single advanced melanoma therapy, possibly identifying several cases at an earlier, more manageable stage.²

Patient quality of life and survival rates also can be considerably improved by early melanoma detection through screening.³ Compared to patients with later-stage diagnoses, those with early-stage melanoma reported a higher overall quality of life. Better physical functioning and reduced levels of anxiety and sadness were linked to early identification using skin biopsies. Patients with more advanced melanoma who had later-onset procedures, on the other hand, experience worsening psychological symptoms and physical health.³

A cost-effectiveness analysis using a Markov cohort model compared the long-term economic impact of early detection and primary prevention of melanoma. It found that daily use of sunscreen could prevent a substantial number of new skin tumors and melanoma deaths and reduce health care costs when compared to early detection strategies such as performing extra biopsies.⁴ There already are programs across the United States that aim to educate the public on the importance of wearing sunscreen; this has, in turn, reduced the prevalence of skin cancer in certain communities. Primary prevention resulted in just 1364 new melanomas and more than $430 million in expenditures per 100,000 individuals, whereas early diagnosis produced 2446 new melanomas and more than $660 million in economic expenses per 100,000 individuals.⁴ It is imperative to acknowledge that skin biopsies remain a vital tool for the early identification of melanoma, particularly in high-risk groups.

By using technologies such as teledermoscopy, the cost-effectiveness of skin cancer referral and consultation can be further enhanced; for example, teledermoscopy for skin cancer referral and triage would result in faster clinical resolution at an average cost of $54.64 per case. This method may reduce the need for redundant in-person consultations and increase the effectiveness of melanoma identification.⁵

Large-scale public health initiatives in skin cancer prevention and early detection have the potential to be very effective, as evidenced by the War on Melanoma project at Oregon Health & Science University (Portland, Oregon). This all-encompassing strategy, which uses cutting-edge technologies, public education, and health care professional training, has improved melanoma outcomes and decreased health care expenditures with encouraging results.⁶

A few tactics can be used to best balance the costs of later-onset procedures and early skin biopsies. These include using advanced technologies such as teledermoscopy and dermoscopy, provider training to increase diagnostic accuracy, public health campaigns to raise awareness and promote prevention, and a comprehensive strategy combining targeted early detection strategies with primary prevention.^5,6 Health care systems can optimize the financial efficiency and clinical results of melanoma treatment by putting these principles into practice.

Compared to later-onset melanoma procedures, early skin biopsies typically are more cost-effective, produce better patient outcomes, and offer psychological advantages, even if they may have a higher initial cost. Health care systems can optimize the trade-off between early detection and cost effectiveness in melanoma management by putting sophisticated technology to use, enhancing provider training, and implementing focused screening programs.^5,6 To support evidence-based policies and guidelines, future research should assess the long-term economic impact of different melanoma prevention and detection measures.

Lifeguards play a crucial role in ensuring water safety, but they also are uniquely positioned to promote skin cancer prevention and proper sunscreen use.^1,2 There are several benefits and challenges to offering skin cancer prevention training for lifeguards.³ We examine the advantages of training, highlight the role lifeguards can play in larger public skin cancer prevention efforts, and address practical techniques for developing lifeguardfocused skin cancer education programs. By providing this knowledge to lifeguards, we can improve community health outcomes and encourage sun-safe behaviors in high-risk outdoor locations.

Benefits of Skin Cancer Prevention Training for Lifeguards

Research has shown that lifeguards are at an elevated risk for basal cell carcinoma, squamous cell carcinoma, and melanoma due to frequent prolonged occupational sun exposure.^1,2,4-6 Therefore, comprehensive education on skin cancer prevention—including instruction on proper sunscreen application techniques and the importance of regular reapplication as well as how to recognize suspicious skin lesions—should be incorporated into lifeguard certification programs. One study evaluating the effectiveness of a skin cancer prevention program for lifeguards found that many of the participants lacked a thorough understanding of the different types of skin cancer.⁵ Another study found that lifeguards at pools in areas where societal norms supporting sun safety are stronger exhibited noticeably more sun protection practices, with regression estimates of 0.22 (95% CI, 0.17-0.26).⁷ Empowering lifeguards with valuable health knowledge during their regular training could potentially reduce their risk for skin cancer,⁴ as they may be more inclined to use sunscreen appropriately and reach out to a dermatologist for regular skin checks and evaluation of suspicious lesions.

Role of Lifeguards in Public Skin Cancer Prevention Efforts

Once trained on skin cancer prevention, lifeguards also can play a pivotal role in promoting sunscreen use among the public. Despite the widespread availability of high-quality sunscreens, many swimmers and beachgoers neglect to regularly apply or reapply sunscreen, especially on commonly exposed areas such as the back, shoulders, and face.⁸ Educating lifeguards on skin cancer prevention could enhance health outcomes by increasing early detection rates and promoting sun-safe behaviors among the general public.⁹ However, additional training requirements might increase the cost and time commitment for lifeguard certification, potentially leading to staffing shortages.^3,7 There also is a risk of lifeguards overstepping their role and providing inaccurate medical advice, which could cause distress or even lead to liability issues.⁷ Balancing these factors will be crucial in developing effective and sustainable skin cancer prevention programs for lifeguards.

Implementing Lifeguard Skin Cancer Training

Implementing skin cancer prevention training programs for lifeguards requires strategic collaboration between dermatologists, and lifeguard training organizations to ensure that the participants receive consistent and comprehensive training.¹⁰ Additionally, public health campaigns can support these efforts by raising awareness about the importance of sun safety and regular skin checks.⁶ Tailored training modules/materials, ongoing technical assistance, and active, multicomponent approaches that account for both individual and environmental factors can increase program implementation in a variety of community settings.

Final Thoughts

Through effective education, lifeguards can potentially have a substantial impact on skin cancer prevention, both among lifeguards themselves and the general public. By promoting proper sunscreen use, lifeguards can help reduce the incidence and mortality associated with skin cancers. Future studies should focus on developing and implementing targeted education initiatives for lifeguards, fostering collaboration between relevant stakeholders, and raising public awareness about the importance of sun safety and early skin cancer detection. These efforts ultimately could lead to improved public health outcomes and reduced skin cancer rates, particularly in high-risk populations that frequently are exposed to UV radiation.

Lifeguards play a crucial role in ensuring water safety, but they also are uniquely positioned to promote skin cancer prevention and proper sunscreen use.^1,2 There are several benefits and challenges to offering skin cancer prevention training for lifeguards.³ We examine the advantages of training, highlight the role lifeguards can play in larger public skin cancer prevention efforts, and address practical techniques for developing lifeguardfocused skin cancer education programs. By providing this knowledge to lifeguards, we can improve community health outcomes and encourage sun-safe behaviors in high-risk outdoor locations.

Benefits of Skin Cancer Prevention Training for Lifeguards

Research has shown that lifeguards are at an elevated risk for basal cell carcinoma, squamous cell carcinoma, and melanoma due to frequent prolonged occupational sun exposure.^1,2,4-6 Therefore, comprehensive education on skin cancer prevention—including instruction on proper sunscreen application techniques and the importance of regular reapplication as well as how to recognize suspicious skin lesions—should be incorporated into lifeguard certification programs. One study evaluating the effectiveness of a skin cancer prevention program for lifeguards found that many of the participants lacked a thorough understanding of the different types of skin cancer.⁵ Another study found that lifeguards at pools in areas where societal norms supporting sun safety are stronger exhibited noticeably more sun protection practices, with regression estimates of 0.22 (95% CI, 0.17-0.26).⁷ Empowering lifeguards with valuable health knowledge during their regular training could potentially reduce their risk for skin cancer,⁴ as they may be more inclined to use sunscreen appropriately and reach out to a dermatologist for regular skin checks and evaluation of suspicious lesions.

Role of Lifeguards in Public Skin Cancer Prevention Efforts

Once trained on skin cancer prevention, lifeguards also can play a pivotal role in promoting sunscreen use among the public. Despite the widespread availability of high-quality sunscreens, many swimmers and beachgoers neglect to regularly apply or reapply sunscreen, especially on commonly exposed areas such as the back, shoulders, and face.⁸ Educating lifeguards on skin cancer prevention could enhance health outcomes by increasing early detection rates and promoting sun-safe behaviors among the general public.⁹ However, additional training requirements might increase the cost and time commitment for lifeguard certification, potentially leading to staffing shortages.^3,7 There also is a risk of lifeguards overstepping their role and providing inaccurate medical advice, which could cause distress or even lead to liability issues.⁷ Balancing these factors will be crucial in developing effective and sustainable skin cancer prevention programs for lifeguards.

Implementing Lifeguard Skin Cancer Training

Implementing skin cancer prevention training programs for lifeguards requires strategic collaboration between dermatologists, and lifeguard training organizations to ensure that the participants receive consistent and comprehensive training.¹⁰ Additionally, public health campaigns can support these efforts by raising awareness about the importance of sun safety and regular skin checks.⁶ Tailored training modules/materials, ongoing technical assistance, and active, multicomponent approaches that account for both individual and environmental factors can increase program implementation in a variety of community settings.

Final Thoughts

Through effective education, lifeguards can potentially have a substantial impact on skin cancer prevention, both among lifeguards themselves and the general public. By promoting proper sunscreen use, lifeguards can help reduce the incidence and mortality associated with skin cancers. Future studies should focus on developing and implementing targeted education initiatives for lifeguards, fostering collaboration between relevant stakeholders, and raising public awareness about the importance of sun safety and early skin cancer detection. These efforts ultimately could lead to improved public health outcomes and reduced skin cancer rates, particularly in high-risk populations that frequently are exposed to UV radiation.

Lifeguards play a crucial role in ensuring water safety, but they also are uniquely positioned to promote skin cancer prevention and proper sunscreen use.^1,2 There are several benefits and challenges to offering skin cancer prevention training for lifeguards.³ We examine the advantages of training, highlight the role lifeguards can play in larger public skin cancer prevention efforts, and address practical techniques for developing lifeguardfocused skin cancer education programs. By providing this knowledge to lifeguards, we can improve community health outcomes and encourage sun-safe behaviors in high-risk outdoor locations.

Benefits of Skin Cancer Prevention Training for Lifeguards

Research has shown that lifeguards are at an elevated risk for basal cell carcinoma, squamous cell carcinoma, and melanoma due to frequent prolonged occupational sun exposure.^1,2,4-6 Therefore, comprehensive education on skin cancer prevention—including instruction on proper sunscreen application techniques and the importance of regular reapplication as well as how to recognize suspicious skin lesions—should be incorporated into lifeguard certification programs. One study evaluating the effectiveness of a skin cancer prevention program for lifeguards found that many of the participants lacked a thorough understanding of the different types of skin cancer.⁵ Another study found that lifeguards at pools in areas where societal norms supporting sun safety are stronger exhibited noticeably more sun protection practices, with regression estimates of 0.22 (95% CI, 0.17-0.26).⁷ Empowering lifeguards with valuable health knowledge during their regular training could potentially reduce their risk for skin cancer,⁴ as they may be more inclined to use sunscreen appropriately and reach out to a dermatologist for regular skin checks and evaluation of suspicious lesions.

Role of Lifeguards in Public Skin Cancer Prevention Efforts

Once trained on skin cancer prevention, lifeguards also can play a pivotal role in promoting sunscreen use among the public. Despite the widespread availability of high-quality sunscreens, many swimmers and beachgoers neglect to regularly apply or reapply sunscreen, especially on commonly exposed areas such as the back, shoulders, and face.⁸ Educating lifeguards on skin cancer prevention could enhance health outcomes by increasing early detection rates and promoting sun-safe behaviors among the general public.⁹ However, additional training requirements might increase the cost and time commitment for lifeguard certification, potentially leading to staffing shortages.^3,7 There also is a risk of lifeguards overstepping their role and providing inaccurate medical advice, which could cause distress or even lead to liability issues.⁷ Balancing these factors will be crucial in developing effective and sustainable skin cancer prevention programs for lifeguards.

Implementing Lifeguard Skin Cancer Training

Implementing skin cancer prevention training programs for lifeguards requires strategic collaboration between dermatologists, and lifeguard training organizations to ensure that the participants receive consistent and comprehensive training.¹⁰ Additionally, public health campaigns can support these efforts by raising awareness about the importance of sun safety and regular skin checks.⁶ Tailored training modules/materials, ongoing technical assistance, and active, multicomponent approaches that account for both individual and environmental factors can increase program implementation in a variety of community settings.

Final Thoughts

Through effective education, lifeguards can potentially have a substantial impact on skin cancer prevention, both among lifeguards themselves and the general public. By promoting proper sunscreen use, lifeguards can help reduce the incidence and mortality associated with skin cancers. Future studies should focus on developing and implementing targeted education initiatives for lifeguards, fostering collaboration between relevant stakeholders, and raising public awareness about the importance of sun safety and early skin cancer detection. These efforts ultimately could lead to improved public health outcomes and reduced skin cancer rates, particularly in high-risk populations that frequently are exposed to UV radiation.