Comment

The Australian community shows a substantial improvement in sun-protection behaviours over the years, with women showing greater improvement than men and with little or few differences between social class. Further improvements will be harder to achieve as the campaigns move from initiation stage to action and maintenance of change, and researchers will require a longer intervention cycle to bring about health gains for more of the population.19 Future intervention planners need to continue frequent reminders for protection and argue for structural change (policy development) that makes it easier for people to embrace protective behaviour. There is a need to develop long-term strategies and interventions so that behaviour change becomes habitual, particularly in young people. In primary-care settings there is a need to encourage general practitioners to offer opportunistic advice on sun protection as well as early diagnosis opportunities.

An Australian cohort analysis for melanoma incidence demonstrates a levelling off in younger groups and even slight reduction compared with older cohorts, in whom incidence continues to rise. This could be due to the effect of publicity campaigns. Mortality is also decreasing in younger groups (<18 years of age) as well as in younger women (>18 years of age). This is likely to be the effect of early diagnosis and treatment rather than the single effect of the primary-prevention campaigns, and health promoters and policy makers cannot be complacent. Such campaigns are expensive and it is necessary to have specific outcome objectives for each specific sun-protection strategy.

Can education and information interventions reduce the risk of skin cancer?

Several groups have conducted studies, few randomised, to learn more about the possible intervention strategies for the reduction of exposure to UVR and the development and

Can year-on-year education campaigns reduce the risk of skin cancers?

implementation of sun-protection policies. Many of these studies had knowledge rather than behaviour as their main outcome measure and so have not been included here. The included studies show that education seems to be the most appropriate way to help populations understand the risks associated with sun exposure and sunburn, and sun-protection strategies. Long-term reminders may have some impact on reducing sun exposure in individuals who have been treated for NMSC but it seems to be the educational intervention at the time of treatment that had the greatest impact.20-22

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