PROGRAMME

Workshop 1: UV index – measurement, modelling, communication
Dr. Cornelia Baldermann, Bundesamt für Strahlenschutz (Federal Office for Radiation Protection)
Dr. Sebastian Lorenz, Bundesamt für Strahlenschutz (Federal Office for Radiation Protection)
The Global Solar UV Index (UVI) is a simple measure of the erythema weighted UV irradiance at the Earth’s surface and an indicator of the potential sunburn risk. In this workshop, an overview of different measurement methods and the state of the art of UV index modelling will be introduced and discussed. Subsequently, a combined measurement and modelling method to improve the accuracy of area-wide messages about the current UV exposure will be presented, and it’s transferability to a worldwide application will be discussed. UV index publication and modern communication methods will be the third main subject of this workshop.
The goal of the workshop is to collect knowledge about methodical and communication methods, to identify scientific gaps, and to formulate recommendations for improving UV monitoring, UV index modelling and UV index communication as part of effective skin cancer prevention.

Workshop 2: Sunbeds - Basics and News (BaN)
Prof. Dr. Jean François Doré, Professor emeritus, France
Prof. Dr. Philippe Autier, International Prevention Research Institute (iPRI), University of Strathclyde, France
The workshop will be animated by researchers who have made significant contributions to the field and will encompass recent basic biological aspects of UV-induced carcinogenesis as well as public health issues. In particular, the impact of prevention policies will be addressed. It will open with a review of UV-induced DNA damage in melanocytes, and a discussion of the prognosis of melanomas associated with sunbed use. Sunbed use in Europe, and the resulting ultraviolet exposure will be discussed. Sunbed legislation in Europe will be presented and compliance with national regulations will be discussed. The amazing “natural experiment” of a melanoma epidemic in Iceland will be used to discuss the links between sunbed use and melanoma incidence. Finally, the burden of skin cancers attributable to sunbed use and the cost savings generated by a reduction of exposure to indoor tanning will be discussed. The important issue of vitamin D will not be missed.

Workshop 3: Secondary Prevention of Skin Cancer: What can we learn from our experiences with skin cancer screening? Insights and international future developments
Prof. Dr. Eckhard Breitbart, Association of Dermatological Prevention (ADP), Germany
Skin cancer screening has been discussed controversy. Projects around the world have tested and evaluated skin cancer screening procedures. So far, Germany is the only country with a population-based skin cancer screening. The workshop will provide insights into previous experiences with screening and evidence using multiple perspectives and disciplines and aims to generate future developments and prospects.

Workshop 4: Sunscreens
Prof. Dr. Antony Young, Professor emeritus, UK

Workshop 5: Childhood sun safety: From problem to solution (Seminar)
Karlijn Thoonen, Researcher University of Maastricht, The Netherlands
Dr. Francine Schneider, Maastricht University, the Netherlands
Dr. Liesbeth van Osch, Maastricht University, the Netherlands
Brian Køster, Danish Cancer Society, Denmark
Peter Alshede Philipsen, Bispebjerg Hospital, Copenhagen University Hospital, Denmark
Heather Walker, Cancer Council Victoria, Australia
Julia Berteletti, Klein Buendel Colorado, U.S.A.
Dr. Arjan van Dijk, Dutch National Institute for Public Health and the Environment, the Netherlands
UVR-exposure and sunburns during childhood are important risk factors for developing skin cancer in later life and should therefore be limited. This seminar will provide insight in various topics concerning UVR-exposure and sun protection of children and adolescents. Recent scientific findings regarding UVR dosimetry measurements, individual and environmental behavioural determinants, intervention implementation and cost-effectiveness of those interventions will be presented and discussed. Moreover, different settings in which children are exposed to UVR, and where intervention programs can therefore be of great relevance, such as the family setting (UVR exposure and sun protection behaviours of parents and the child itself), the school setting (implementation and evaluation of sun safety programs) and the physical environment (effective environmental interventions), will be discussed.

Workshop 6: How to Conduct Effective Small Scale, Low Budget Interventions
Dr. Peter Dalum, Danish Cancer League, Denmark
In this workshop, we focus on one of the main challenges we often have in prevention: only having funding for a small project*. In these cases the interventions developer often have to make shortcuts in many of the phases of the development process that one would use in a full scale intervention project.
The aim of the workshop is experience sharing in all project phases. Therefore, we will address:

• How to choose the right target group for the intervention: Do we want to reach many people in an ’easy’ target group or less people in a ’difficult’ target group?
• How you can collect data prior to your intervention development
• How to use ‘real life stories’ and behavioral journalism strategies as part of interventions
• How to involve opinion leaders in the campaign dissemination
• How to use alternative media strategies
• How to collect available data on program use/effect

In the workshop, all participants will be invited to share experiences, and the aim is to create a set of practice-based recommendations that can be used as an inspirational guide.
*We define low budget as projects of less than 50.000 EUR but whether this is considered ‘low budget’ both depends on actual costs in any given country and size of the country/target group.

Workshop 7: Basics of Prevention - New Insights in Skin Cancer Etiology
Dr. Rüdiger Greinert, Secretary General, Euroskin, Germany

14.00-18.00 - Workshop 8: Occupational Skin Cancer & UV Protection at the Workplace (Seminar)
Prof. Dr. Swen Malte John, Head of Institute of Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University Osnabrück, Germany
Dr Marc Wittlich, Head of Radiation Unit, IFA , Institut fur Arbeitsschutz
In cooperation with World Skin Health Day 2019, partly sponsored by ILDS (International League of Dermatological Societies)
Occupational activity is one of the most relevant factors influencing solar radiation (SR) exposure. Alone in Europe about 14.5 million outdoor workers (OW) are exposed to SR for at least 75 % of their working time. Primary prevention is thus essential to avoid longer-term costs and decrease the disease burden. In professions with increased sun exposure, specific measures of awareness, protection and systematic dermatological screening provide value for money in terms of a healthy work environment. Currently, 90 per cent of medical costs related to skin cancer are spent on treatment, while less than 10 per cent go to prevention. This session will present new evidence of the magnitude of the challenge for outdoor professions and look into various workplace prevention strategies in orderto appraise the importance of preventive action.

Workshop 9: An introduction to Social Marketing principles and how they can help you deliver programmes that will valued and have impact.
Prof. Dr. Jeff French, Strategic Social Marketing, UK
In this workshop participants will be introduced to Social Marketing principles and its six programme design concepts. The workshop will give attendees an opportunity to see how Social Marketing principles and design concepts can be applied to increase the effectiveness and efficiency of health promotion programmes. The workshop will be interactive in nature and will be illustrated by examples from around the world.

Workshop 10: Patient Organisations
Prof. Dr. Eckhard Breitbart, Association of Dermatological Prevention (ADP), Germany
Self-help organizations are characterized by well-informed and committed patients, who are willing to be actively involved in skin cancer-related research, prevention and treatment. Needs-based research can only work with the participation of patients. Nevertheless, there have been few initiatives so far that enable and strive for consistent patient involvement. For this reason, the Workshop aims to bring patients and researchers together. The goal is to show different ways of involving patient organizations in scientific work and to discuss future possibilities and developments.

09.00-09.45: Skin cancer and climate change
Prof. Dr. Robyn Lucas, College of Health and Medicine, The Australian National University, Australia
Skin cancer is primarily caused by exposure to UV radiation that is inappropriately high for the individual’s skin type. ‘Exposure’ is determined by the level of UV radiation and the individual’s behaviour in relation to sun exposure and protection. Future changes in atmospheric composition and dynamics will affect recovery of stratospheric ozone, and thus also affect levels of UV radiation at Earth’s surface. Changing weather – particularly temperature and precipitation – will alter sun exposure behaviour. Thus, climate change will alter skin cancer risk –not uniformly across the globe, but determined by tropospheric and stratospheric composition and current temperature (and acclimatisation).

09.45-10.05: Sunscreen use, indoor tanning and skin cancer
Prof. Dr. Marit.B. Veierød, Department of Biostatistics, University of Oslo, Norway
Recommendations to reduce skin cancer risk include protection from solar ultraviolet radiation (UVR) and avoidance of artificial UVR from indoor tanning. Sunscreen use is recommended for sun protection in addition to clothing and shade. Assessing the association between sunscreen use and skin cancer risk is challenging, and the main body of evidence comes from observational studies. This presentation will present recent results, and discuss important challenges when studying sunscreen use and risk of cutaneous squamous cell carcinoma (cSCC) and melanoma in observational studies. Indoor tanning is an avoidable risk factor and characterizing the risk of cSCC and melanoma associated with indoor tanning is important to set the stage for policies regulating indoor tanning.

10.05-10.25: Melanoma: measuring the burden, assessing the causes
Dr. Roberto Zanetti, IACR, International Association of Cancer Registreis Turin, Italy
The long (over the last 6 decades) series of impact data, incidence, survival and mortality, will be reviewed.
Until around 1975, etiological hypotheses have been mainly based on clinical and anecdotal observations.
Then, formal etiological studies based on the methods of modern epidemiology, developed in two phases. In the first one, mainly represented by case-control studies, causal clues were tested comparing exposure anamneses in the two groups. Less frequent have been the cohort studies, and poor of results (or rich in poor results) the ecological studies.
In the second phase, the genomic era, the focus shifted on genes. The main study design remained the case control, often combining laboratory genes testing, semi-objective measurement of skin characteristics, and anamnestic assessment of the exposure (mainly to UV).
The principal results of the two phases, and their interpretation, will be discussed.

Discussion of Topic of invited speaker 1
Formulation of recommendations Chair: Robyn Lucas

Discussion of Topic of invited speaker 2
Formulation of recommendations Chair: Marit B. Veierød

Discussion of Topic of invited speaker 3
Formulation of recommendations Chair: Roberto Zanetti

4 Sessions of selected poster flashtalks (3x5min) and abstract talks (3x10 min)

14.15-15.00: WHO – Worldwide skin cancer prevention (successes and needs)
Dr. Emilie Van Deventer, Team Leader Radiation Program, Department of Public Health, Environmental and Social Determinants of Health, World Health Organisation, Switzerland

15.00-15.20: Sunbed use in Europe
Dr. Mariano Suppa, Department of Dermatology, Université Libre de Bruxelles, Hôpital Erasme, Brussels, Belgium
Background. Sunbeds are first-group carcinogen but are still commonly used in Europe. Euromelanoma is a pan-European skin cancer prevention campaign.
Objectives. To compare several European countries in terms of prevalence, determinants and risks of sunbed use.
Methods. Euromelanoma participants filled in questionnaires containing demographics and risk factors, including type/duration of sunbed use. Multivariate analyses were employed to assess factors independently associated with sunbed use in each country.
Results. In total, 227 888 individuals from 30 countries participated. Prevalence of sunbed ever use was 10.6%, with high geographic variability according to latitude, sunshine, cultural and economic factors. Ever sunbed use was independently associated with nevus count >50, atypical nevi, lentigines and suspicion of melanoma.
Conclusions. Sunbed use is significantly associated with well-recognized risk factors for melanoma. Our data on prevalence of use may have public health relevance for future, tailored interventions aimed at reducing sunbed use in Europe.

15.20-15.40: What can we learn from social marketing for skin cancer prevention
Prof. Dr. Jeff French, CEO Strategic Social Marketing & Professor, University of Brighton, UK
In this session Professor Jeff French will set out tips to avoid wasting time, money and effort in the design of health promotion programmes. The learning presented in this session is based on a distillation of on evidence and experience from the fields of health promotion, social marketing, community engagement, behavioural sciences and management science. The session will be illustrated with practical real life examples from around the world. Participants will leave the session with understanding, tools and techniques for ensuring the development of effective, efficient and community supported programmes of action.

15.40-15.55:
Prof Dr Swen Malte John, Institute of Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University Osnabrück, Germany

Discussion of Topic of invited speaker 1
Formulation of recommendations Chair: Emilie van Deventer

Discussion of Topic of invited speaker 2
Formulation of recommendations Chair: Mariano Suppa

Discussion of Topic of invited speaker 3
Formulation of recommendations Chair: Jeff French

4 Sessions of selected poster flashtalks (3x5min) and abstract talks (3x10 min)

08.30-09.15: Strategies for primary and secondary prevention in different health systems
Prof. Dr. Harry de Koning, Public Health and Screening Evaluation, Erasmus MC, The Netherlands

09.15-09.35: Improvements in environmental prevention
Dr. Cornelia Baldermann, Federal Office for Radiation Protection, Germany
The number of UV-induced skin cancer cases continues to rise steadily. Accordingly, campaigns are being carried out worldwide to raise awareness of the health risk associated with UV radiation and to encourage appropriate protective behavior (behavioral prevention). However, studies show that although the health risk is known, the corresponding behavior is lacking. This forces the question: What has to be done that UV protection can easily be practiced? The answer: Optimize the environment people live in. Activities to transform people´s environment affect and involve different stakeholders, and establishing such measures need engagement and a clear proof of health and financial benefits. On the basis of experiences in Germany, this presentation attempts to outline the various aspects that need to be considered when establishing environmental prevention measures, and to provide information on how environmental prevention - in synergy with behavioral prevention - can be successfully implemented.

09.35-09.55: Can the increasing melanoma rates in the European countries be changed? Learnings from The Danish Sun Safety Campaign 2007 – 2017
Dr. Peter Dalum, Danish Cancer League, Denmark
Melanoma Incidence rates in populations with European descendants have increased ever since cancer registration began. Main preventable reasons for the increase is the changed behavior in the natural sun and the use of sunbeds. In Australia and New Zealand, broad uv-prevention campaigns was launched in the eighties and have shown to be effective. The methods and experience from these countries may not be directly transferred to a European setting since conditions are not similar regarding uv-exposure and norms of sun protection behaviors. In 2007, the Danish Sun Safety Campaign was launched in a partnership between the Danish Cancer Society and the philanthropic foundation TrygFonden as Denmark had the highest incidence rates of skin cancer outside the Australian continent. The campaign was based on the learnings from Australia but modified to a European setting. The aim of this presentation is to describe the overall campaign model and the main results from the campaign period.

09.55-10.25: Digital Interventions: Successes and failures in skin cancer prevention and early detection across the continents
Dr. Monika Janda, Professor for Behavioural Science, the University of Queensland
Dr. Carolyn Heckman, Associate Professor of Medicine, Rutgers Cancer Institute of New Jersey, USA
Increasingly, behavioural skin cancer interventions are delivered directly to a person’s personal digital devices, including mobile phones, tablets and laptop devices, using text messaging, mobile apps or online web-based platforms. At the same time, communication via social media platforms such as Facebook, Twitter, Instagram and others is increasing and is often used to share information and advice from health professionals, consumer organisations, and people outside the health and medical fields. This presentation will provide an overview of important recent developments, provide examples of relevant work, and discuss how new interventions should be designed and delivered for maximal engagement and effect.

Discussion of Topic of invited speaker 1
Formulation of recommendations Chair: Harry de Koning

Discussion of Topic of invited speaker 2
Formulation of recommendations Chair: Cornelia Baldermann

Discussion of Topic of invited speaker 3
Formulation of recommendations Chair: Peter Dalum

4 Sessions of selected poster flashtalks (3x5min) and abstract talks (3x10 min)

14.00-14.45: The solar spectrum and skin cancer
Prof. Dr. Petra Boukamp MD, German Cancer Research Center, Heidelberg, and Institute for Environmental Medicine, Düsseldorf, Germany
Every year, the diagnosis of new skin cancer incidences exceeds the combined incidence rates of cancers from the breast, lung, prostate, and colon. In fact, Non-melanoma skin cancer (NMSC), and in particular the keratinocyte cancers, i.e. the basal cell carcinoma (BCC) and the cutaneous squamous cell carcinoma (cSCC), are the most common cancers in the Caucasian population worldwide. While BCCs, though highly destructive, only rarely metastasize, cSCCs and particular cSCC that develop in organ transplant recipients as a consequence of immunosuppression, are increasingly aggressive with a metastasis risk estimate of >10%. Once metastasized any successful treatment has yet to be identified. It is without doubt that exposure to sunlight is the leading cause of human skin cancer and the carcinogenic role of the two ultraviolet wavelengths of the solar spectrum, UVB (280-320 nm) and UVA (320 - 400 nm) are well documented. Meanwhile wavelengths beyond UV radiation, the visible light (VIS: 400 - 770 nm) and near infrared radiation (IRA: 771 - 1440 nm), have been shown to exert damage to human skin cells, thus also deserve attention for their potential contribution to human skin cancer. Commonly, the different wave lengths are analyzed individually in order to identify their specific signature. However, the solar spectrum as a whole may exert interactive regulatory mechanisms that are likely to modify the individual action spectra. Understanding the combined action of the different wavelength of the solar spectrum should, therefore, become an important aspect of future studies. Likewise, besides the well-studied mutagenic potential of UVA und UVB radiation, sunlight also counteracts tissue homeostasis, causing epidermal dysregulation (hyperkeratosis or acanthosis), modifying the stroma (solar elastosis) and influencing the immune system (immunosuppression), requesting also for a more global view for a better understanding and hopefully successfully combat of skin cancer initiation and progression.

14.45-15.05: Treating UV-induced skin cancer by targeting the immune system
Prof. Dr. Scott Byrne, University of Sydney, Australia
When skin is exposed to UV, a cascade of cellular and molecular events are initiated that lead to the downstream activation of regulatory immune cells. As a consequence, both local cutaneous and systemic immunity is suppressed, particularly adaptive immune responses, which are required to detect and destroy cancer cells. We know from animal models and clinical trials in humans that interfering with one or more of these UV-triggered immunological events can have a profound effect on skin tumour incidence, growth and metastasis. Indeed, for aggressive skin cancers like melanoma, CTLA-4- and PD-1-targeted immunotherapy has proven highly successful. But these check-point inhibitors don’t work for everyone. Alternative approaches and new therapies, possibly ones that target other UV-activated immune pathways, are therefore urgently needed. Understanding the mechanisms by which UV drives immune suppression will allow for the development of new immune-targeted treatment options for UV-induced skin cancers.

15.05-15.25: Skin Cancer (Risk-) Biomarkers
Dr. Rüdiger Greinert, Secretary General, Euroskin, Germany

Discussion of Topic of invited speaker 1
Formulation of recommendations Chair: Petra Boukamp

Discussion of Topic of invited speaker 2
Formulation of recommendations Chair: Scott Byrne

Discussion of Topic of invited speaker 3
Formulation of recommendations Chair: Rüdiger Greinert

4 Sessions of selected poster flashtalks (3x5min) and abstract talks (3x10 min)

Do we still need skin cancer prevention following the therapy revolution?
David Whiteman AM, FAFPHM, FAHMS, FSCCA (Hon)
Acting Director : QIMR Berghofer Medical Research Institute
Head, Cancer Control Laboratory : QIMR Berghofer Medical Research Institute
Coordinator, Melanoma and Skin Cancer Research Centre, Brisbane, Queensland, Australia

Undeniably, the advent of targeted and immune therapies has been a “game-changer” for many patients with melanoma. Indeed, these new approaches to treating previously fatal cancers have had such revolutionary impact that some are now questioning whether there is any need to pursue preventive activities. It is important to remember however, that therapies do nothing to reduce the incidence of disease, and while they may confer survival benefits to some, the benefits are not shared equally by all those afflicted. Therapies are also not without harm or financial cost. A holistic approach to melanoma control would combine evidence-based strategies targeting prevention, early detection and treatment in the most cost-effective manner possible.

10.00-10.15: The role of economics in advancing skin cancer prevention
Dr. Gery Guy, Centers of Disease Control and Prevention (CDC), USA
Economics can play an important role in the prevention of skin cancer. Economics provides important tools such as cost-effectiveness and cost-benefit analysis, behavioral economics, quasi-experimental designs and simulation modeling. The application of these tools can help expand the empirical basis for decision making and help assure scare resources are used wisely. This presentation will examine the various economic tools available and provide examples of how these tools have been applied in helping to address the increasing burden of skin cancer.

10.15-10.30: Health economic evidence for skin cancer prevention – past, present and future.
Prof. Dr. Louisa Gordon, Team Head – Health Economics, QIMR Berghofer Medical Research Institute, Australia
As skin cancer rates continue to rise in many countries, investment in primary prevention initiatives are urgently required. To contribute to advocacy efforts, evidence on the cost burden, cost-effectiveness of skin cancer prevention interventions and return on investment analyses can inform and help persuade decision-makers to fund prevention programs. However, despite a growing body of work demonstrating the strong cost-effectiveness of prevention programs, economic evidence has had varying success in positively changing policy for skin cancer prevention. This presentation will outline how far health economics has come to contributing to policy impacts and the next challenges of producing and communicating economic findings to support skin cancer prevention.

10.30-10.45: Speaker TBC