Sun Safety and Young People

Skin cancers are the most common form of cancers in New Zealand ¹. The mortality rate from skin cancer is among the highest in the world ². It is widely recognised that skin cancer prevention requires a focus on both environmental and individual behaviour change in order to reduce harmful exposure to ultraviolet radiation
(UVR)*.

While the historical focus on skin cancer prevention has been on increasing individual behaviour and awareness, there is now recognition of the need for increased focus on sun protective policies that also involve shade provision, including in schools ³.

Children: A Target Group for Skin Cancer Prevention

There is strong evidence that excessive exposure to UV radiation during childhood and adolescence is a risk factor for developing skin cancer later in life ⁴. It is also known that superficial skin cancers (basal and squamous cell) result from cumulative life-time ultraviolet (UV) exposure and up to 80% exposure is commonly received during childhood ⁵. It is also estimated that the majority of a person’s lifetime UV exposure occurs during childhood ⁶. Episodes of sunburn, particularly in childhood and adolescence, also increase the risk of melanoma ⁷. Children therefore represent an at risk group. Limiting UV exposure during school years could reduce incidence of these cancers in later life.

Given the strength of evidence linking melanoma to sunburn during childhood and adolescence, various international and national health agencies advise that effective sun protection needs to begin early in life ⁸.

In the New Zealand context, education about skin cancer prevention and the reduction of sun exposure in educational settings has been identified as one of the highest priorities for melanoma control ⁹. Children must therefore be a key target group for prevention and education programmes ^{10, 11}.

An emphasis on sun protection and skin cancer prevention in schools is important for two reasons 1) they are places where infants and young children spend much of their time 2) they also provide opportunities through staff professional development and curriculum incorporation for both staff and students to learn about appropriate strategies for sun protection.

Children in New Zealand Schools

For more information on students attending New Zealand schools please see the Department of Statistics website.

SKIN CANCER statistics:

• Between 250 and 300 New Zealanders are dying from skin cancer every year ¹².
  Skin cancer is by far the most common cancer affecting New Zealanders.
  Of the 3 most common skin cancers, melanoma is the most serious.
• NZ has one of the highest melanoma death rates in the world. The most recent statistics are for 2000, showing 1,660 new cases of melanoma and 253 reported deaths from melanoma in that year. This represents an age-standardised rate of 4.5 deaths per 100,000 ¹³.
• Skin cancer costs the New Zealand health system about $33 million a year, making skin cancer one of the most expensive cancers for the NZ health system ¹⁴.
  It has been estimated that, for every death from skin cancer, an average of 17.4 potential years of life are lost ¹⁵.
• The vast majority of skin cancers are preventable - it has been estimated that over 90% of melanomas in Australasia are attributable to sunlight exposure.
• Exposure before the age of 20 years is a particularly strong risk factor for melanoma incidence ¹⁶.

 

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1. O'Dea, D. (2000). The costs of skin cancer to New Zealand. Wellington: Wellington School of Medicine, University of Otago.
2. Primary Prevention Expert Working Group to the Cancer Control Steering Group. Primary Prevention. Wellington: Ministry of Health, 2003.
3. Reeder, A.I. Report to the Skin Cancer Steering Committee to inform development of the Skin Cancer Control Programme Plan 2005. Social & Behavioural Research in Cancer Group. Dunedin School of Medicine, University of Otago.
4. World Health Organization. (2002). “Sun protection: An essential element of Health-Promoting Schools,” WHO Information Series on School Health: Document Seven. Geneva: World Health Organization. WHO/NPH/02.6. WHO/SCHOOL/02.1
5. Reference
6. American Academy of Pediatrics. (1999). “Ultraviolet light: A hazard to children.” Pediatrics 104: 328-333. http://www.aap.org/policy/re9913.html
7. Ibid.
8. WHO, 2002: Ibid, web unpaginated
9. Elwood, M. & Glasgow, H. (1993). The prevention and early detection of melanoma in New Zealand. Wellington: Cancer Society of New Zealand and Department of Health.
10. The Cancer Society and Health Sponsorship Council (2003) have outlined the need for a comprehensive national shade strategy in NZ noting that this is a relatively new area of focus in NZ with a lack of information, guiding principles and consistent standards for shade.
11. While shade is an important area requiring greater focus, including the development of consistent guidelines and standards, ensuring that awareness about personal protective strategies is widespread among children and their caregivers perhaps offers the greatest health gain and most cost-effective of skin cancer control.
12. New Zealand Health Information Service www.nzhis.govt.nz/stats/cancerstats.html
13. Ministry of Health. 2004. Cancer: New Registrations and Deaths 2000. New Zealand Health Information Service. www.nzhis.govt.nz/stats/cancerstats.html
14. O’Dea, D. The costs of skin cancer to New Zealand. Cancer Update in
    Practice: Issue 2, 2000.
15. Armstrong BK, Kricker A. How much melanoma is caused by sun exposure? Melanoma Research 1993; 3: 395-401.
16. Weinstock, MA et al. Nonfamilial cutaneous melanoma incidence in women associated with sun exposure before 20 years of age. Pediatrics 1989; 84(2):199-204.