Executive summary
This paper begins by laying out the information about the commonality of the skin cancer in Australia. The first section also describes the extent of the problem that Slip! Slop! Slap! campaign attempted to change. The second section is concerned with the distribution of the problem in the population. The third section lays out the findings on the risk factors of skin cancer. The remaining parts of the paper present social and political dimensions of the campaign, provide its analysis as well as offer recommendations for the future actions aimed at the reduction of the problem.
Commonality
According to the International Agency for Research on Cancer, the incidence of skin cancer in Australia is the highest in the world (as cited in Staples, Elwood, Burton, Williams, Marks, & Graham, 2006). The most commonly diagnosed type of cancer in Australia is non-melanoma skin cancer (NMSC). It is estimated that approximately 9 percent of the total spending on cancer is dedicated to this type of cancer. Moreover, in the span from 2000 to 2001 over a quarter of a billion dollars was spent on the diagnosis and treatment of NMSC (Staples et al., 2006). Unlike other types of skin cancer, NMSC is rarely registered by the national cancer registry offices. Therefore, data from self-reported diagnoses has been gathered and assessed in order to define trends in the incidence of the disease. The results from the surveys revealed that there is a positive trend in the growth of cancer since 1985 (Staples et al., 2006). The data also suggested an increase in the rates of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) (Staples et al., 2006). Out of 57,215 respondents across the country, 18 percent testified having ever been treated for some form of skin cancer (Staples et al., 2006). Around a half of interviewees reported being treated in the period of 12 months before the survey. In more than 30 percent cases the diagnosis was confirmed clinically (Staples et al., 2006). Around 2 percent of Australia’s population were treated for NMSC in 2002 (Staples et al., 2006).
Population
According to the Australian Institute of Health and Welfare (AIHW), 13,283 cases of melanoma skin cancer will be diagnosed in 2016 with 3.8 percent of lethality (AIHW, 2016a). It is estimated that melanoma skin cancer will be the fourth most common type of cancer in Australia in 2016 (AIHW, 2016a).
The study conducted by Staples et al. (2006) suggests that there is a significant difference in incidence rates between BCC and SCC. For example, the incidence rates of SCC in the age group below 40 that took part in the survey were too unsubstantial to make accurate measurements, whereas BCC rates revealed that women are more susceptible to the disease (Staples et al., 2006). On the other hand, for the age group older than 40 years rates of squamous cell carcinoma were higher for men. It was extrapolated from the study that the risk of being diagnosed with BCC was also higher for men than for women (Staples et al., 2006). No correlation of NMSC rates with socioeconomic status was discovered (Staples et al., 2006).
According to AIHW, there was an almost two-fold increase in the incidence rates of melanoma from 1982 to 2016 (AIHW, 2016b). The estimated age-standardised rates of the disease for 2016 are 49 cases per 100,000 (AIHW, 2016b).
Risk factors
Even though skin cancer is a preventable disease, the data from AIHW reveals that the estimated number of deaths from NMSC in 2016 will be 560 (AIHW, 2016b). There is ample evidence suggesting that regular use of sunscreen leads to the reduction of the risk of SCCs and melanoma. However, the data for BCCs is not substantial enough to make a conclusive statement about the link between the use of sunscreen and the reduced risk of BCCs (AIHW, 2016b).
The numerous studies point to the fact that over-exposure to the sun leads to the higher risk of developing skin cancer (AIHW, 2016b). However, there is no direct correlation between the level of intermittent UV exposure and the incidence of melanoma. The chances of developing the disease are directly correlated with the individual’s exposure to UV radiation (AIHW, 2016b). Studies also suggest that solariums and other artificial tanning methods sometimes emit up to 5 times amount of summer sun radiation, thus highly increasing risks of developing some type of skin cancer (AIHW, 2016b).
The risk of developing the disease considerably increases with the presence of a first-degree relative with melanoma (AIHW, 2016b). According to the numerous studies, there is a greater chance of being susceptible to spreading melanomas if there is a history of the disease incidence in the family (AIHW, 2016b). Moreover, studies suggest that the people with the great number of moles on the body are more likely to develop skin cancer.
Campaign approach
Slip! Slop! Slap! campaign was initiated by the Anti-Cancer Council of Victoria (ACCV) in 1980 (Montague, Borland, & Sinclair, 2001). Its aim was to discourage individuals from intermittent over-exposure to UV radiation. The campaign used an animated clip in which a seagull named Sid encouraged inhabitants of the southern state of Victoria to wear clothes and headwear as well as sunscreen during daytime under the sun (Montague et al., 2001). It was a limited program with the annual commitment in funds around AUS$50,000 (Montague et al., 2001). After eight years of its initiation, Victorian Health Promotion Foundation launched the SunSmart program that was a continuation of the ACCV campaign (Montague et al., 2001).
The social and political environment of late 1980 provided a significant boost for the program (Montague et al., 2001). The uptick of the interest in the environment movement for the reduction of the damage to the ozone layer, which is associated with the higher level of UV radiation, provided a backdrop for the campaign. Moreover, the information about the presence of an ozone hole over the territories of Australia, New Zealand and South America accelerated the acceptance of program messages (Montague et al., 2001). In addition, the government support helped to launch a comprehensive program SunSmart with the aim to encompass governmental, business and social organizations. Even though both social and environmental contexts of the time were conducive to changing people’s behaviour, a comprehensive approach was needed to alter cultural and social norms (Montague et al., 2001).
Analysis of campaign
There is a substantial data on the changes in the attitudes of Victorians towards sun exposure (Montague et al., 2001). An increase in the proportion of population wearing sunscreen or a headwear item between 11 a.m. and 3 p.m. has been documented (Montague et al., 2001). Moreover, the studies indicate the presence of the significant downward trend in the sunburns since 1988 (Montague et al., 2001). The data from the national surveys reveals a considerable decrease in the proportion of the population who are willing to get a suntan. For example, in 1988, around 60 percent of Victorians thought favourably about the idea of suntan (Montague et al., 2001). However, after only one decade the trend radically changed and only 38 percent of the population were likely to get a suntan in 1988 (Montague et al., 2001).
Slip! Slop! Slap! campaign made a great contribution towards structural and institutional changes in a wide array of organizations. By the end of 2000 almost three-quarters of all primary schools in Victoria received SunSmart accreditation (Montague et al., 2001). However, there was a critique of the effectiveness of the campaign. A study conducted by Paul, Tzelepis, Girgis and Parfitt aimed at the exploration of acceptance of UV protection messages by the groups of 12 to 17-year-olds suggested a tendency for distancing from cartoon aspects of the program in most of the adolescent groups (Paul, Tzelepis, Girgis, & Parfitt, 2003).
Future action
To reduce the problem, all school curriculums in the country have to be changed to accommodate educational information about UV protection and policy for compulsory hat wearing. Moreover, all government organizations should either develop their own sun protection policies and procedures or get accreditation from SunSmart. The national standard-setting body must work towards the development of a severe regulatory framework for the solarium industry. In addition, extensive media campaigns need to be launched in order to decrease the numbers of solariums.
References
AIHW. (2016a). Melanoma skin cancer. Web.
AIHW. (2016b). Skin cancer in Australia. Web.
Montague, M., Borland, R., & Sinclair, C. (2001). Slip! Slop! Slap! and SunSmart, 1980-2000: Skin Cancer Control and 20 Years of Population-Based Campaigning. Health Education & Behavior, 28(3), 290-305.
Paul, C., Tzelepis, F., Girgis, A., & Parfitt, N. (2003). The Slip Slop Slap years: Have they had a lasting impact on today’s adolescents? Health Promotion Journal of Australia, 14(3), 219-221.
Staples, M. P., Elwood, M., Burton, R. C., Williams, J. L., Marks, R., & Graham, G. G. (2006). Non-melanoma skin cancer in Australia: The 2002 national survey and trends since 1985. Health Promotion Journal of Australia, 184(1), 6-10.