RISD Thesis: Research


In the article titled Melanoma Epidemiology and Public Health, authors Berwick, Erdei and Hay strongly state their disappointment in the progress made regarding the education of melanoma and public health:

“Unfortunately, there is little sound evidence on which to move forward in public education and awareness of skin cancer. This is a critical juncture for the development of such evidence. Currently, different factions promulgate somewhat confusing recommendations: some advise avoiding the sun, and others advise enjoying a moderate amount of sun exposure. The tanning industry is even promoting the use of tanning parlors to develop a ‘‘safe’’ tan.”

Based on the discoveries during the research phase, the most effective approach is to focus on the primary prevention and early detection of skin cancer in men and women between birth and 20 years old. The main reasons are based on scientific research that shows females make up 1% of all melanoma incidences by age 15 and males reach the 1% mark by age 20. Furthermore, a vast percentage of females will be affected with skin cancer by age 30, while males will see an increase in incidences by age 50.

I believe there is a true opportunity to change behavior in teenagers and adults through the introduction of products and education in developmental years. This approach was inspired by psychologist Erik Ericksons’ theory on psychosocial development and the principles of behavior cusps.

The following is an excerpt from authors Bosch and Fuqua’s paper titled Behavioral Cusps: A model for selecting target behaviors:

“The concept of a cusp may help in the selection and prioritization of behavior-change goals. It reminds us that some apparently insignificant behaviors of questionable face validity may dramatically affect the learner. For example, Staats (1996) describes the way in which he learned to tap his fingers and make different sounds. A seemingly insignificant (or annoying) behavior such as finger tapping could be a cusp for a percussionist or for the development of keyboard skills!”

I find that it may be possible to blend preventative sun behaviors throughout a person’s lifetime, but only if those solutions are in-line with helping achieve the needs of the human’s developmental stages.



According to the U.S. National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program, it is estimated that 68,130 Americans were diagnosed with melanoma in 2010, from which 8,700 men and women died (approximately one every hour). In a thirty year span U.S. incidence rates continue to raise, while U.S. death rates remain virtually the same (Fig. 1). Through better detection practices physicians have managed to spot this disease at earlier stages and as a result keep mortality rates nearly unchanged, although incidences continue to increase.[1]

Fig. 1: Malignant Melanoma Incidence and Mortality Rates per 100,000 person-years in the US

Fig. 1: Malignant Melanoma Incidence and Mortality Rates per 100,000 person-years in the US

As stated in SEER (Fig. 2), malignant melanoma is most common in Caucasian males aged 50+; it is also the most common cancer for females in their mid‑twenties (only second to breast cancer in the 30 year old group bracket.)[2]

Fig. 2: Malignant Melanoma Incidence Rates of Males and Females in the US

Fig. 2: Malignant Melanoma Incidence Rates of Males and Females in the US

At first glance, this curve is visually alarming and focuses attention on the male demographic. However, a different and closer look at gender incidence rates separated by age tells a different story. For the first 50 years, females are mostly at risk of falling victim to this disease.

Fig. 3: Malignant Melanoma Incidence Rates by Age Group in the US

Fig. 3: Malignant Melanoma Incidence Rates by Age Group in the US

Fig. 4: Malignant Melanoma Incidence Rates in the US, 0-29 Year Old Age Group    

Fig. 4: Malignant Melanoma Incidence Rates in the US, 0-29 Year Old Age Group


Fig. 5: Malignant Melanoma Incidence Rates in the US, 30-49 Year Old Age Group    

Fig. 5: Malignant Melanoma Incidence Rates in the US, 30-49 Year Old Age Group


Fig. 6: Malignant Melanoma Incidence Rates in the US, 50+ Year Old Age Group

Fig. 6: Malignant Melanoma Incidence Rates in the US, 50+ Year Old Age Group



As reported by a study on www.chemweek.com by Kline and Co. the market for personal suncare products is expected to grow globally to $4.8 billion by 2011, the article states:

“Consumers are becoming more aware of the need for protection against UV rays, not only at the beach, but every day… Demand is steadily increasing as UV protection enters more personal care segments such as daily wear, anti‑wrinkle lotions, and children’s and baby care products.”

The current melanoma prevention and early detection market consists primarily of awareness campaigns and uv-protective products, although few technological companies have unsuccessfully attempted to introduce solutions. Personal awareness and medical examinations continue to be the most effective form of prevention and early detection methods.



Australia is geographically situated in a high intensity location for ultraviolet rays and it also has a high-risk light colored skin population. The work of the Australian government and their campaign of Slip-Slop-Slap, encouraging residents to “slip on a shirt, slop on sunscreen, and slap on a hat” is not a one time trial, but instead an on-going top-to-bottom, multimillion dollar campaign heavily targeted to young adults. [3] [4] Below are two campaign samples from The Cancer Council Western Australia

Other efforts to curb skin cancer incidences take the form of collaboration campaigns, as in the case of Marc Jacobs and the New York University Langone Medical Center. Further collaborations come from the Swiss creative agency Euro RSCG and their creation of sculptures out of POST-IT™ notes around public pools, and the ad agency Wirz/BBDO in Zurich with the use of guerrilla marketing by placing of morgue tags on people’s toes who were found in a public park asleep in the sun

In the United States, the indoor tanning sector is state regulated, some states still allow access to minors as young as 14 years of age although these machines “can provide five times the ultraviolet radiation of the midday sun.” One of the major campaigns for the prevention of skin cancer is in the form of legislation, through the lobbying and banning of indoor tanning to underage users. [5] [6]

According to the list of high risk factors for skin cancer published in The Mayo Clinic Proceedings, family and personal history of cancer rank the highest for melanoma risks, amongst low tanning ability and childhood sunburns[7]. As a designer there is nothing I can do about genetic factors such as cancer history and tanning ability, however, I can raise awareness regarding early detection and introduce products for the education of sun effects and the prevention of childhood sunburns.



While considering skin cancer as my research topic I met Ted, a 55 year old male from New England:

“Gunther, your thesis is my reality. I get radiation three times a year to keep everything at bay. Luckily no melanoma just yet! But all of this could have been prevented in the 60’s, when I was outside all the time playing football and baseball and going to the beach and thinking it was cool to peel off my skin. What was I thinking, I am a level beneath being an albino.”

Upon suggestion from Dr. Weinstock, I researched the Aim At Melanoma Foundation, where I read the story of Charlie Guild, a young female with sights on medical school, who succumbed to melanoma after graduating from Brown University:

"When Charlie was diagnosed with 4th stage melanoma, she was 25 years old. She had decided to take off a year or two before devoting the next ten years of her life to the study of medicine. She wound up on Wall Street, and the girl who didn’t know a stock from a bond was promoted to managing analyst just 2 months before she became ill… She died on Nov. 24, 2003, eight months after her initial diagnosis.”

After conducting field observation in Rhode Island and Florida, it became imperative to connect with people directly and start the process of evaluating their knowledge of the sun and its effects. This communication would yield personal opinions about the sun, as well as educate me on opportunities to implement possible solutions.

Through the use of social media, I reached out to friends and families to conduct interviews about care and prevention from sun and skin cancer. This approach provided me with the necessary information to build my initial online survey (see sample below) and, as a result, gather a larger sample, as well as receive answers to much more targeted questions.

The survey results made clear the necessity to reach to teenagers and children to conduct further interviews and create new focus groups. Another fact found in the research stage is the lack of concern for the sun in people under the age of 25. Adult awareness about sun care and prevention is not often consistent or accessible [8], but although most survey takers answered that they take less than adequate measures to protect themselves from sun damage, one hundred percent of parents stated that they take all precautions to protect their child from ultraviolet rays.


  1. Lee KC, Weinstock MA. “Melanoma Is Up: Are We Up to This Challenge?.” Journal of Investigative Dermatology 129.7 (2009): 1604

  2. Howard K Koh, et al. “Melanoma incidence and mortality among US whites, 1969-1999.” JAMA: The Journal Of The American Medical Association 288.14 (2002): 1719-1720. MEDLINE. EBSCO. Web. 24 Oct. 2010

  3. “Slip Slop Slap Seek Slide.” Cancer Council Australia. Web. 8 May 2011. Video

  4. “Sun Worshippers Need A Slap Of Reality | The Australian.” The Australian | The Australian Homepage | TheAustralian. Web. 8 Mar. 2011. Video

  5. “Are Health Police Trying To Burn Tanning Salons Or Save Young Lives? – HealthPop – CBS News.” Breaking News Headlines: Business, Entertainment & World News – CBS News. Web. 5 May 2011. Video

  6. “Tanning Restrictions for Minors.” National Conference of State Legislature. Web. 3 Feb. 2011. Video

  7. Edward T. Creagan, et al. “Malignant Melanoma in the 21st Century, Part 1: Epidemiology, Risk Factors, Screening, Prevention, and Diagnosis.” Mayo Clinic Proceedings 82.3 (2007): 364-380. Academic Search Premier. EBSCO. Web. 18 Jan 2011.

  8. Weinstock, Martin A. “Cutaneous Melanoma: Public Health Approach to Early Detection.” Dermatologic Therapy 19.1 (2006): 26-31. Academic Search Premier. EBSCO. Web. 6 May 2011