What can be done to reduce personal ultraviolet radiation exposure? In: Hill D, Elwood JM, English DR, editors. Prevention of Skin Cancer. Dordrecht: Springer Netherlands; 2004. pp. 241-58. [DOI: 10.1007/978-94-017-0511-0_13]

Sunscreen Increasingly Overshadows Alternative Sun-Protection Strategies

The present study assessed perceptions of effective sun-protection strategies among the general public and whether these perceptions have changed in recent years. During five summers from 2007/2008 to 2011/2012, 4217 adolescents and adults living in a region with very high levels of solar UV radiation participated in annual, cross-sectional telephone surveys. Respondents' perceptions of the most effective sun-protection strategy were measured with a single open-ended question. In all survey years, sunscreen was the by far most frequently nominated sun-protection strategy, with an average mention rate of 71.0 %. The tendency to nominate sunscreen increased significantly over the 5-year study period and on average, was more common among adolescents compared to adults (81.6 vs 60.0 %) and females compared to males (73.6 vs 68.3 %). Despite respondents' increasing tendency to nominate sunscreen as the most effective sun-protection strategy, health experts have voiced concerns about flawed application practices. Current sun-protection hierarchies indicate that protective clothing and shade are better options.

Sun behaviour in Canadian children: results of the 2006 National Sun Survey

Childhood sun exposure is a particularly important determinant of skin cancer, yet little data are available for children. This paper describes sun behaviour among Canadian children for the summer of 2006. As part of the Second National Sun Survey (NSS2), 1,437 parents reported on the time spent in the sun, and the frequency of sun protection behaviours and sunburning for one of their children aged 1 to 12 years. Analysis was carried out using complex survey procedures in SAS and STATA. The majority of children (94%) spend at least 30 minutes in the sun on a typical summer day; however, regular sun protection is only commonly reported for young children (1 to 5 years) and involves covering their heads and wearing sunscreen (85%). The frequency of other protective behaviours is much lower, and sun protection decreases with age. Older children are also twice as likely to spend extended time in the sun and to get a sunburn. Among older children, boys are more likely to cover their heads and girls are more likely to wear sunscreen. Regular sun protection among Canadian children is low, given their sun exposure. Heavy reliance on sunscreen is consistent with previous reports and indicates that other measures, such as seeking shade and wearing protective clothing, need to be promoted. Riskier sun behaviour among older children may reflect decreased parental control, as well as changing attitudes and peer pressure, and highlights the importance of adult role models and targeted interventions for this age group.

Sun Protection Policies and Practices at Child Care Centers in Massachusetts

We assessed the relationship between sun protection policies and practices at child care centers in Massachusetts. We hypothesized that centers with sun protection policies were more likely to have regular sun protection practices in place compared to centers without these policies. We conducted a telephone survey with directors or assistant directors at 327 child care centers during the summer of 2002. The main outcome measure was sun protection practices, which included time spent outside during mid-day and the use of sunscreen, hats, and protective clothing by the majority of children assessed over the last 5 program days. The 36-item survey also inquired about the center's sun protection policy and included demographic questions. Most centers (73%) reported having a written sun protection policy. Sun protection policies were positively associated with reported sunscreen (chi squared = 14.63, p = 0.0001) and hat use (chi squared = 30.98, p < 0.0001) and inversely associated with time outside (chi squared = 10.76, p = 0.001). Seventy-seven percent of centers followed recommended sunscreen practices. However, centers were far less likely to have recommended hat use (36%) and protective clothing (1.5%) practices. A formal sun protection policy may be an effective way to increase sun protection practices in the child care setting. Further research should assess this relationship in other states. Improving and expanding existing state regulations may be a reasonable strategy to increase sun protection at child care centers.

The future incidence of cutaneous melanoma within the U.K

BACKGROUND

The incidence of cutaneous malignant melanoma continues to rise in the U.K., where since the 1970s malignant melanoma has seen the largest increase in incidence rates compared with other major cancers. To counteract this rise, sun awareness campaigns have been introduced in this and several other countries since the 1980s with the object of encouraging people to limit their exposure to strong sunshine and to avoid sunburn in the expectation that these interventions will act favourably on skin cancer incidence.

OBJECTIVES

To predict the incidence of cutaneous malignant melanoma in the British population over the next half-century as a consequence of either a stabilization or a reduction in lifetime risk of melanoma for recent and future birth cohorts so that cancer services can be planned appropriately over the coming years.

METHODS

An age-cohort model has been developed that estimates future incidence rates of melanoma in the U.K.

RESULTS

The results suggest that the benefits of intervention strategies, assuming that these will translate eventually into a downturn in melanoma incidence, may not be seen for another 30 years or so, by which time the predicted age-standardized rate of melanoma may be around twice that presently observed.

CONCLUSIONS

Prevention of deaths from melanoma depends on both reducing incidence and achieving earlier diagnosis. This analysis has indicated that the former is unlikely to be realized in the U.K. for some decades, and so early detection of suspected lesions, with prompt surgery to remove confirmed tumours, is paramount if mortality from melanoma is to be kept in check.