Sunbed use 2007–2015 and skin cancer projections of campaign results 2007–2040 in the Danish population: repeated cross-sectional surveys

Abstract

ObjectiveTo evaluate the effect of the Danish Sun Safety Campaign 2007–2015 on the prevalence of sunbed use and to model future effects on the skin cancer incidences 2007–2040.DesignThe study has a repeated, cross-sectional design.SettingExposure to ultraviolet radiation is the main risk factor for skin cancer. Denmark has the highest prevalence of sunbed use reported and one of the highest incidences of skin cancer worldwide.ParticipantsDuring 2007–2015, survey data were collected for 37 766 Danes, representative of the Danish population with regards to age, gender and region.InterventionsIn 2007, an ongoing long-term antisunbed campaign was launched in Denmark.Primary and secondary outcome measuresSunbed use was evaluated by annual cross-sectional surveys. Skin cancer incidence was modelled in the Prevent programme, using population projections, historic cancer incidence, sunbed use exposure and relative risk of sunbed use on melanoma.ResultsThe prevalence of recent sunbed use in Denmark was reduced from 32% and 18% to 13% and 8% for women and men, respectively. The campaigns results during 2007–2015 are estimated to reduce the number of skin cancer cases from more than 5000 (746malignant melanoma, 1562 SCC, 2673 BCC) totally during 2007–2040. Keeping the 2015 level of sunbed use constant by continued campaign pressure or introduction of structural interventions would potentially prevent more than 750 skin cancer cases annually in 2040 and 16 000 skin cancer cases in total during 2007–2040.ConclusionWe have shown the value of prevention and of long-term planning in prevention campaigning. Sunbed use was reduced significantly during 2007–2015 and further reductions are possible by structural interventions. Consequently, significantly fewer skin cancer cases are anticipated during 2007–2040. The Danish Parliament has population support to enforce structural interventions to avoid a large burden of this disease.

Indoor tanning prevalence after the International Agency for Research on Cancer statement on carcinogenicity of artificial tanning devices: systematic review and meta‐analysis

“…Such findings are illustrated by Denmark specifically, where no age limit for sunbed use exists, but after a 10-year antisunbed campaign, indoor tanning prevalence among women dropped from 32% in 2007 to 13% in 2015. 34 Denmark's prevalence is now similar to other European countries where indoor tanning laws are in place. Brazil (since 2009) and Australia (since January 2016) have national bans on indoor tanning and prevalence is now very low in these countries, i.e.…”

“…Interestingly, countries without restrictions for minors also showed a reduction in indoor tanning over time. Such findings are illustrated by Denmark specifically, where no age limit for sunbed use exists, but after a 10‐year antisunbed campaign, indoor tanning prevalence among women dropped from 32% in 2007 to 13% in 2015 . Denmark's prevalence is now similar to other European countries where indoor tanning laws are in place.…”

“…The IARC 2009 statement has been further strengthened and supported by multiple initiatives, including the Surgeon General's Call to Action in 2014 and skin cancer prevention campaigns such as the Centers for Disease Control and Prevention ‘Burning Truth’ campaign in the U.S.A., the 10‐year Danish Sun Safety Campaign and the distribution of approximately 10 million sugar packets in coffee shops with sun‐exposure care messages in Portugal . Newer strategies targeting mainly young female audiences make use of social media platforms such as Facebook and Instagram .…”

Benefit–Cost Analysis of the Danish Sun Safety Campaign 2007–2015: Cost Savings from Sunburn and Sunbed Use Reduction and Derived Skin Cancer Reductions 2007–2040 in the Danish Population

“…This analysis was based on (1) annual population-based surveys regarding the Danish population's behavior in the sun [17][18][19]; (2) skin cancer projections from surveys [12,13];…”

“…The results of the Sun Safety Campaign during 2007-2015 included annual reductions in the rates of sunbed use and sunburn of 6% and 1%, respectively. The skin cancer projections (2007-2040) also showed reductions in the number of skin cancer cases of 16,000 and 14,000 as a result of reductions in sunbed use and sunburn, respectively, compared with no change in behavior [12,13].…”