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From Australia to Brazil: Sun Worshippers Beware: Skin Cancer Incidence Is Increasing Worldwide as Fair-Skinned Populations Seek the Sun without Realizing the Risks. Sarah Cumberland and Claudia Jurberg Report on How Australia and Brazil Are Tackling This Health Issue

2009; World Health Organization; Volume: 87; Issue: 8 Linguagem: Inglês

1564-0604

Sarah Cumberland, Cláudia Jurberg,

Skin Protection and Aging

For the past 10 years on one single day in November, more than 1500 physicians have taken to the streets and beaches of Brazil in the fight against skin cancer. annual National Campaign to Prevent Skin Cancer mobilizes Brazilians to attend one of thousands of mobile clinics set up in tents at beaches and town squares in hundreds of cities nationwide for a skin check and to learn more about how to prevent skin cancer. Organized by the Sociedade Brasileira de Dermatologia (Brazilian Dermatological Society), the campaign attracted more than 40 000 people in 2008, an increase of 40% on 2007. According to a survey carried out on the day, 8 November 2008, more than 27 000 (62.3%) people who were examined said that they had come because of the media campaign. The media played an essential role, says Dr Selma Schuartz Cernea, campaign coordinator. News stories that stressed the importance of regular skin examinations were run in national radio, television, print media and the Internet. Ten per cent of people who attended were diagnosed with some type of skin cancer. Of the cases identified on the campaign day in 2008, more than 3000 were basal cell carcinomas (non-melanomas) and 354 were malignant melanomas, the most deadly type of skin cancer. Unfortunately, the majority of people who attended the national day (65.4%) confessed to exposure to the sun without protection, says Cernea. Brazil's tropical climate and thousands of kilometres of beaches have contributed to building a nation of sun-worshippers with European descendants making up about 50% of the population. Tanning is particularly a problem for teenagers who are less likely to use sunscreen or other protective measures but whose habits today will have an impact on skin cancer incidence in later A study published in the American journal Photochemistry and Photobiology in 2005 revealed that 90% of high-school students surveyed in Porto Alegre, Brazil, were aware of the dangers of sun exposure and skin cancer, but thought that tanning improved their appearance so considered it was worth the risk. Less than 50% of them reported using sunscreen in summer and less than 3% used it in winter. [ILLUSTRATION OMITTED] According to the Instituto Nacional do Cancer (National Cancer Institute), skin cancer continues to be the most common type of cancer for both men and women in Brazil. According to data from the Ministry of Health, more than 7000 Brazilians had treatment or surgery for skin cancer within the public system in 2008. This number has more than doubled in l 0 years, from 3000 in 1998, while the population increased only by about one fifth from 161 million to 190 million. [ILLUSTRATION OMITTED] Dermatologic surgeon Dr Joaquim Mesquita Filho believes that the incidence of melanoma in Brazil is underestimated because it does not require compulsory notification. In his private clinic in Rio de Janeiro, Mesquita Filho saw 11 cases of melanoma between January and May of 2009 but was not required to notify the health data system about any of them. Marceli Oliveira Santos, a statistician from the Division of Information at the National Cancer Institute, said cancer incidence data are only an estimate because Brazil does not record these data for the entire population. The National Cancer Institute only receives records from 28 locations, mainly in the capital. Of these, only 17 have produced data for at least two years. Worldwide, skin cancer is on the rise because it is still viewed by many people as a fairly benign condition, almost as an inconvenience, says Dr Hayes Gladstone, director of dermatologic surgery at Stanford University, United States of America. And many national cancer societies, including the American Cancer Society, have chosen to focus their efforts and limited resources on cancers which have an across-the-board higher mortality rate such as breast and colon cancers. …