400:
The number of life-years lost and loss of productivity both have a bearing on the financial cost of the disease. The direct and indirect expenses of skin cancer in the
Australian state of New South Wales (NSW) have been investigated. Direct costs included those resources related to skin cancer management, and indirect costs were concerned with premature mortality and morbidity. Review of 150 000 skin cancer patients in NSW (2010) revealed a total lifetime cost estimation of AU$ 536 million, with 72% of this cost related to direct costs, and the remaining 28% to indirect costs; the direct costs were higher in females and indirect costs higher in males. Prevention initiatives make up an important part of financial expenditure for skin cancer funding and investments. Prevention programs are a productive tool, as they beneficially influence attitudes and behaviours towards skin cancer, but also deliver positive financial returns. A 2009 study analysed the economic impact of prevention programs such as SunSmart.
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358:. The first two are the most prevalent forms. Although generally non-melanoma carcinomas have lower associations with mortality than melanomas, fatalities occur, with 534 reported deaths in 2011. 434,000 Australians in 2008 underwent treatment for non-melanoma carcinomas. Melanomas have the highest correlation with mortality, killing 1,544 in 2011. Australia shares with New Zealand, the highest diagnosis of melanoma throughout the world and also has the highest diagnosis of non-melanoma carcinomas. In 2011, New Zealand surpassed the Australian rate for invasive melanoma cases and now has the highest melanoma incidence in the world.
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lifestyle, is presumed to be a dominant factor in the risk, due to the effect of high UV levels on fair skin. The UV Index (UVI), defined as the sun-burning strength of ultraviolet rays (UVR), in Canada ranges between 1 and 10. The
National Institute of Water and Atmospheric (NIWA) research recorded that New Zealand (similar latitude to Australia) the UVI exposure often exceeds 13 and is 40% more than that recorded at comparable latitudes in North America. In order to maintain effective prevention and national awareness Australia used a variety of campaigns and initiatives beginning in the early 1980s. The
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191:, and in the 1970s, with tanning salons and solariums becoming increasingly popular, had developed into a worldwide tanning industry. Although the tanning industry in Australia is relatively small by international standards, it has quadrupled in size since 1992. The tanning industry promotes tanning as a process to stimulate higher levels of vitamin D, associating it with reduced likelihood of sunburn and
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not financially justify national public screening. A 2003 study analysing the effectiveness of skin cancer screening was implemented in northern
Germany. Study doctors received 8 hours of training and over a year screened 19% of Schleswig-Holstein’s population. Initially melanoma detection increased 34%. After 5 years the population experienced over 50% decrease in melanoma mortality.
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part of skin cancer prevention. SunSmart recommends wearing protective clothing, hats, sunscreen, seeking shade from the sun and wearing UV protective eyeware. SunSmart also provides recommendations on how to choose the right protective products. Regular skin checks are another important preventive step.
399:
Australia spends more than $ 2 billion annually treating cancer, with skin cancer the most costly. From 2005-15 over $ 300 million was spent annually on diagnosis, treatment and pathology-related costs of skin cancer. With $ 512.3 million spent in 2010 on melanoma carcinomas, costs continued to rise.
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campaign was initiated in 1981 introduced a seagull singing a catchy jingle “Slip on a shirt! Slop on some sunscreen! and Slap on a hat!”, promoted awareness and entered
Australian culture. It was so successful that it remained part of the SunSmart slogan, which was updated to read, Slip, Slop, Slap,
172:
Australians culturally identify with the "bronzed Aussie" stereotype,, viewing it as a positive body image associated with recreational sport and exercise-orientated lifestyles. With over 90% of melanomas derived through contact with the sun, skin cancer preventive initiatives in
Australia strived to
379:
Awareness and early detection are the most efficient tools for avoiding skin cancer and are the basis of many effective prevention campaigns in
Australia. Prevention initiatives such as SunSmart promote awareness by advocating effective sun protective methods, sun risk awareness and are an integral
222:
In
February 2009, the Victorian Government introduced license changes, including banning under 18s, consistent with the revised Australian standard, released in January 2009. Victorian solarium legalisation was revised in late 2010, strengthening controls around citing evidence of age documents for
390:
The standard for skin cancer screening in
Australia is self-assessment and occasional clinic screening. Consistent with Australian guidelines for public skin cancer screening, Cancer Council Australia does not recommend annual or regular skin assessment because low national melanoma occurrences do
296:
ultraviolet radiation related outcomes. These increased risks were specifically associated with younger participants, with tanning and solarium use relatively popular among teens and young adults. An increase of 59% in risk of developing melanoma was associated with people who used sun beds before
287:
radiation has internationally been categorised as carcinogenic. Artificial UVR primarily used in tanning salons and sunbeds, has generated concern among health officials and it was observed to considerably heighten the risk of developing cutaneous malignant melanoma. A study in 2010 found strong
255:
New South Wales, Queensland, ACT and
Tasmania introduced legislation applying these standards in 2009 and 2010. In 2011, the New South Wales government called for public submissions in relation to a proposal to extend the age ban to those under 30. In February 2012 the New South Wales Government
219:. The 2008 regulations required solaria to obtain a license, display health warnings. In Victoria, those under 16 and people with fair skin were banned from solaria and 16-17 year olds were required to have parental consent whereas in South Australia and Western Australia, under 18s were banned.
305:
Australia and New
Zealand have the world's highest skin cancer rates. Factors include the large percentage of the population with fair skin prone to skin cancers and the high levels of ambient UV radiation. Similarly the Anglo-Celtic ancestry of many New Zealanders together with their outdoor
366:
Australia has recorded increased mortality rates of melanoma from the 1950s, continuing to rise until the late 1980s and beginning to steady from 1990 onwards. Australia has some of the world's highest melanoma-related fatalities—double the mortality rates of south and central Europe. The
329:
Media promotion and education remains a vital and effective tool in Australian skin cancer awareness strategy. Despite its effectiveness members of the public remain indifferent or unaware of the risks caused by inefficient sun protection and skin care.
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announced its intention to ban tanning beds, starting in 2014. In October 2013, the Victorian parliament passed an official ban on solaria to take effect by 2015. As of 2018, there was illegal solarium use in Australia, often advertised on Gumtree.
813:
Gies P, Javorniczky J, Henderson S, McLennan A, Roy C, Lock J, Lynga C, Melbourne A, Gordon L. UVR emissions from solaria in Australia and implications for the regulation process Photochemistry and Photobiology 2011; 87 (1):
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Department of Health and Human Services Tasmania. Guidelines for the operation of solaria in Tasmania. Public Health Act 1997. Population Health, ed. Hobart, Australia: Department of Health and Human Services Tasmania,
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Hirst, Nicholas; Gordon, Louisa; Gies, Peter; Green, Adèle C. (1 January 2009). "Estimation of avoidable skin cancers and cost-savings to government associated with regulation of the solarium industry in Australia".
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and more than 1,000 related fatalities from 1988-2003. The study found strong evidence that continued investment and support for SunSmart was economically sound and presented beneficial outcomes for Australia.
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started in the 1980s and continued to invest and promote awareness through government-funded mass media strategies. Although Australia has one of the highest national rates of skin cancer, mortality trends in
139:
kills over 2,000 each year, with more than 750,000 diagnosed and treated. Tanning became embedded in Australian culture and proved to be a controversial issue because of its popularity among teens and
678:
Levine, Jody A.; Sorace, Michael; Spencer, James; Siegel, Daniel M. (1 January 2005). "The indoor UV tanning industry: A review of skin cancer risk, health benefit claims, and regulation".
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The first government-funded mass media skin cancer initiative began in Australia during 2006. Its skin cancer awareness message was delivered through radio, television and printed mediums.
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Makin J, Dobbinson SJ. Changes in solarium numbers in Australia following negative media and legislation. Australian & New Zealand Journal of Public Health 2009; 33 (5): 491-494.
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evidence supporting association between indoor tanning salon use and increased risk of developing melanoma. The study demonstrated strong correlations between increased risk of
501:
Cust, Anne E.; Armstrong, Bruce K.; Goumas, Chris; Jenkins, Mark A.; Schmid, Helen; Hopper, John L.; Kefford, Richard F.; Giles, Graham G.; Aitken, Joanne F. (1 January 2010).
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Australian Capital Territory. Radiation Protection (Tanning Units) Amendment Regulation 2010 (No 1) made under Radiation Protection Act 2006. Subordinate Law SL2010-29, 2010.
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New South Wales Government. Radiation control regulation 2003 made under the Radiation Control Act 1990, as at 29 May 2009. Reg 615 of 2003. Part 4A - Tanning units, 2009.
1111:
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Standards Australia/Standards New Zealand. Australian/New Zealand Standard AS/NZS 2635 (Solaria for cosmetic purposes): Standards Australia/Standards New Zealand, 2008.
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Victorian Government. Radiation Amendment (Tanning Units and Fees) Regulations 2008 Under section 139 of the Radiation Act 2005. Vol. STATUTORY RULE No. 167/2008, 2008.
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Shih, Sophy Ting-Fang; Carter, Rob; Sinclair, Craig; Mihalopoulos, Cathrine; Vos, Theo (1 January 2009). "Economic evaluation of skin cancer prevention in Australia".
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Victorian Government. Radiation (Tanning Units Amendment) interim regulations 2007 Under section 139 of the Radiation Act 2005. Vol. STATUTORY RULE No. 148/2007, 2007.
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began in 1987, led by an Australian foundation focused on promoting skin cancer awareness. Social education, challenging societal and cultural ideals, is one of
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South Australia. Radiation protection and control (cosmetic tanning units) regulations 2008 under the Radiation protection and control act 1982, 2008.
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demonstrated positive health impacts, was cost effective. The Victoria-based program returned $ 3.60 for every $ 1 invested. It concluded that
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1050:"The Growing Burden of Invasive Melanoma: Projections of Incidence Rates and Numbers of New Cases in Six Susceptible Populations through 2031"
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Department of Health. Management licence conditions for the possession of a commercial tanning unit. Melbourne: Victorian Government, 2011.
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Doran, Christopher M.; Ling, Rod; Byrnes, Joshua; Crane, Melanie; Searles, Andrew; Perez, Donna; Shakeshaft, Anthony (23 September 2015).
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1158:"Despite one of the worst skin-cancer rates in the world, and a beach bag full of awareness campaigns over the years, [online]"
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Girschik, J.; Fritschi, Lin; Threlfall, T.; Slevin, T. (2 April 2008). "Deaths from non-melanoma skin cancer in Western Australia".
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371:. Sun protection, other forms of primary protection, early detection and increased public awareness have had the greatest impact.
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salons are widely used and available throughout Australia. Tanning has been a phenomenon since the 1800s, with medical use of
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Skin cancer prevalence by country in 2008. Australia and New Zealand have the highest rates of skin cancer, shown in red.
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methods for promoting awareness and through its many successes now functions throughout all of Australia, under state
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The solarium industry is regulated on a state by state basis. The first states to regulate solarium use (2008) were
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503:"Sunbed use during adolescence and early adulthood is associated with increased risk of early-onset melanoma"
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ensure all staff have completed training in carrying out skin assessments and determining exposure times;
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628:"Trends in melanoma mortality in Australia: 1950–2002 and their implications for melanoma control"
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Radiation Safety Act 1975 Radiation Safety (General) Regulations 1983. Western Australia, 2008.
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927:"'It's criminal, it should be stopped': Melanoma survivor issues warning on illegal solariums"
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provide a consent form outlining the risks of solarium use for customers to read and sign;
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1101:"New Zealand Skin Cancer Primary Prevention and Early Detection Steering Committee"
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introduction of preventive campaigns correlate with the transition to decreases in
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Sinclair, C.; Foley, P. (1 November 2009). "Skin cancer prevention in Australia".
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users, despite correlations between tanning and an increased risk of developing
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Whiteman, David C.; Green, Adele C.; Olsen, Catherine M. (June 2016).
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Queensland Health. Section 47A, Radiation Safety Act 1999, 2009.
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sight evidence-of-age documents for those who may be under 18;
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195:, with increased well being and feelings of happiness.
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The Australian standard requires that operators must:
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Australian and New Zealand Journal of Public Health
48:. Unsourced material may be challenged and removed.
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147:. Australia experienced relative success through
680:Journal of the American Academy of Dermatology
626:Baade, Peter; Coory, Michael (1 August 2005).
395:Economic implications of prevention campaigns
311:Slide (on sun glasses), Seek (shaded areas).
236:ban people with very fair skin (skin type I);
8:
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960:"Skin cancer facts & stats - SunSmart"
464:"Skin cancer facts & stats - SunSmart"
245:complete a skin assessment of each client;
215:following the death of skin cancer victim
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1178:"Non-melanoma - Cancer Council Australia"
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108:Learn how and when to remove this message
1054:The Journal of Investigative Dermatology
964:Skin cancer facts & stats - SunSmart
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468:Skin cancer facts & stats - SunSmart
275:are predominantly caused by exposure to
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251:ensure clients wear protective eyewear.
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260:Ultraviolet radiation and skin cancer
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1245:Sun protective clothing - SunSmart
1117:from the original on 14 June 2018.
645:10.1111/j.1467-842X.2005.tb00211.x
346:Skin cancer has three main forms:
239:provide mandatory health warnings;
14:
1218:from the original on 14 June 2018
937:from the original on 6 March 2018
1271:"Sun protective hats - SunSmart"
903:. News.com.au. 15 October 2013.
580:10.1111/j.1365-2133.2009.09459.x
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149:skin cancer prevention campaigns
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901:"Tan ban passes Vic parliament"
733:10.1016/j.healthpol.2008.07.003
507:International Journal of Cancer
33:needs additional citations for
1275:Sun protective hats - SunSmart
568:British Journal of Dermatology
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871:"Solariums banned across NSW"
362:Trends in melanoma mortality
1479:10.1016/j.ypmed.2009.09.008
1371:Australian Family Physician
1176:Australia, Cancer Council.
996:Cancer Causes & Control
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692:10.1016/j.jaad.2005.07.066
57:"Skin cancer in Australia"
1433:10.1186/s12889-015-2267-3
1365:Sinclair, Rodney (2012).
1067:10.1016/j.jid.2016.01.035
1008:10.1007/s10552-008-9150-9
342:Metastatic melanoma cells
187:, emerging popularity of
439:Cancer Council Australia
273:squamous cell carcinomas
173:change this perception.
137:Skin cancer in Australia
1512:Integumentary neoplasia
1331:"Sunglasses - SunSmart"
352:squamous cell carcinoma
1132:"Sunscreen - SunSmart"
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277:ultra violet radiation
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1212:Ministry of Health NZ
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269:basal cell carcinomas
230:ban people under 18s;
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1136:Sunscreen - SunSmart
875:ABC News (Australia)
348:basal cell carcinoma
42:improve this article
1507:Cancer in Australia
1467:Preventive Medicine
1108:www.sunsmart.org.nz
877:. 4 February 2012.
444:Health in Australia
199:Solarium regulation
1367:> "Skin Checks"
1301:"Shade - SunSmart"
408:prevented 103,000
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369:melanoma mortality
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1420:BMC Public Health
1182:www.cancer.org.au
1156:Turner, Jessica.
519:10.1002/ijc.25576
513:(10): 2425–2435.
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