Skin cancer control in Australia. The balance between primary prevention and early detection

Marks, Robin

doi:10.1001/archderm.131.4.474

Cited by 24 publications

(11 citation statements)

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“…and SunSmart national public information campaigns have sought to change public attitudes and behaviors. [12][13][14] Recent surveys indicate that Australians increasingly favor more use of sun protection. 15 The alarming rise in melanoma mortality among Australians appears to have plateaued since 1985.…”

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confidence: 99%

“…16 These education programs may have contributed to these developments. 13 In Australia, the United States, and Europe, a variety of school education interventions have been developed to help change children's sun protection behaviors. These interventions have led to shortterm changes in knowledge, attitudes, and self-reported behaviors in day care and elementary school populations.…”

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confidence: 99%

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A Community-based Randomized Trial Encouraging Sun Protection for Children

Dietrich¹,

Olson

Sox³

et al. 1998

Pediatrics

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ABSTRACT. Objective. We evaluated the impact of an intervention promoting sun protection behavior among children 2 to 11 years of age through schools and day care centers, primary care practices, and recreation areas.Methods. Ten towns in New Hampshire were paired, then assigned randomly to intervention or control status. The multicomponent SunSafe intervention was provided to children and caregivers through primary care practices, day care centers, schools, and beach recreation areas. Training support and materials were provided by the SunSafe project, but project staff had no direct contact with children or parents in providing the intervention. All intervention components promoted the same message: avoid the sun between 11 AM and 3 PM, cover up using hats and protective clothing, use sun block with a sun protection factor >15, and encourage sun protection among family and friends. The impact of the intervention was determined by observing children's sun protection behavior at the beach during baseline compared with 1 year later. The primary outcomes of interest were changes in the proportion of children per town using at least some sun protection and changes in the proportion of children fully protected. Children were clustered by town, with the town thus being the unit of analysis.The primary care practice component included one practice meeting for clinicians and staff at which project staff presented background on skin cancer and how to promote its prevention; a sun protection office system manual based on our previous work, which provided specific direction on how to share responsibility among office staff and clinicians in carrying out routines that promote sun protection; and educational posters, pamphlets, and self-adhesive reminder notes designed to enhance sun protection counseling. SunSafe removable tattoos and stickers were offered to children at well-child and illness visits during the summer months.Schools each received three project staff visits: a brief visit with the principal to describe the intervention and to answer questions; an in-service program to educate teachers about skin cancer and to introduce curricular materials; and help with one parent outreach program. Larger day care centers each received one project staff visit. An additional six smaller day care centers received curricular materials through the mail but no visits. Two similar sets of curricular materials were used, one for grade schools and the other for preschools and day care centers. Both emphasized the importance of sun protection rather than the danger of skin cancer. Materials emphasized dynamic activities modeled after the "Slip, Slop, Slap" and "SunSmart" programs and included new material developed to suit regional needs. Both manuals offered structured plans but also provided a variety of activities from which teachers could choose. Teachers agreed to devote a minimum of two class periods to these materials.For recreation areas, lifeguards in each of the intervention communities attended an in-service meeting, dur...

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confidence: 99%

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confidence: 99%

A Community-based Randomized Trial Encouraging Sun Protection for Children

Dietrich¹,

Olson

Sox³

et al. 1998

Pediatrics

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“…Im Jahr 1991 berichteten Borland et al [5], dass die "cover yourself against skin cancer"-Kampagne in Australien zu einer signifikanten Verbesserung des Arbeitsbekleidungsschutzes von Freilandarbeitern geführt hat. Darüber hinaus konnte in Australien gezeigt werden,dass "ein enormer Anstieg des öffentlichen Wissens" und eine Änderung in "social style of life" stattgefunden haben [9,29,30]. So führte der signifikante Anstieg des Wissens um das Sonnenschutzverhalten zur Abnahme der Anzahl von Personen, die sich an Abb.…”

Section: Weltweite Aktionenunclassified

“…Die Mortalität von Frauen (aller Altersgruppen) in Schottland und Frauen (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) in England und Wales nahm durch Aufklärung und Screening leicht ab.Die Mortalitätsrate in Australien sowie unter jün-geren Jahrgangskohorten und Frauen in den USA stabilisierte sich.Die Mortalitäts-rate von Frauen in einer "Aufklärungsre-gion" in Italien, verglichen mit Kontrollstädten, nahm ab [10,15,26,28,36,37].…”

Section: Sekundäre Prävention Von Hautkrebsunclassified

“…Auf der Grundlage von Trends in Kohorten kann erwartet werden, dass die Mortalität in den folgenden Jahren abnehmen wird. Hinzu kommt, dass in Australien aufgrund von Screening und Bevölkerungsinformation die Diagnose des malignen Melanoms früher gestellt wurde und die durchschnittliche Tumordicke bei Diagnosestellung abnahm [30]. Die Mortalität nahm infolgedessen in geringerem Maße zu als die Inzidenz.…”

Section: Sekundäre Prävention Von Hautkrebsunclassified

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Pr�vention von Hautkrebs

et al. 2003

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Including malignant melanoma, basal cell carcinoma, and squamous cell carcinoma, skin cancer is the cancer with the highest incidence worldwide. Its incidence is increasing more rapidly than that of all other kinds of cancer. It is necessary to slow down this trend through preventive steps in order to reduce morbidity and mortality rates and to decrease the financial burden on the health systems. This goal could be achieved through primary (prevention of risk factors) and secondary prevention (early diagnosis and screening). This essay describes the necessity, realization, and success of these kinds of intervention programs. It especially portrays the procedures in Germany as they have been practiced for the last 15 years by the Society of Dermatology Prevention and German Cancer Aid.

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Melanoma and Tumor Thickness

Richard

Grob²,

Avril³

et al. 1999

Arch Dermatol

105

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Objective: To test the basic assumption of campaigns for early diagnosis of melanoma, ie, prognosis is correlated with the delay in the diagnosis. Design: Prospective study of the correlation between delays to diagnosis, assessed using a questionnaire, and the Breslow thickness as a prognosis marker. Setting: Dermatology departments in France. Patients: Fivehundredninetyconsecutivepatients,referred within 12 weeks after resection of cutaneous melanoma. Main Outcome Measures: Assessment of 5 successive time intervals from the first time the patients realized that they had a lesion until the resection of the melanoma, and results of the correlation between each time interval and tumor thickness (Breslow). Results: There is a positive but weak correlation between tumor thickness and the delay to identify a lesion as suspicious (r = 0.17; P = .009). However, this delay tends to be short for the thickest tumors. There is a negative correlation between tumor thickness and the delay to seek medical attention (r = −0.20; PϽ.001). This delay was shorter for nodular melanoma. No correlation is found between melanoma thickness and physicians' delays. Conclusions: Poor prognosis can be accounted for by aggressive rapidly growing tumors rather than by delays. In well-informed populations, campaigns for early diagnosis of melanoma may thus no longer have a major impact on prognosis, unless they are focused on subgroups less accessible to information and medical care.

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Skin cancer control in Australia. The balance between primary prevention and early detection

Cited by 24 publications

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A Community-based Randomized Trial Encouraging Sun Protection for Children

A Community-based Randomized Trial Encouraging Sun Protection for Children

Pr�vention von Hautkrebs

Melanoma and Tumor Thickness

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