Editorial: Time to shed our thick skin on melanoma

The sun and New Zealand make for uncomfortable companions. Photo / Getty Images

Editorial

The sun and New Zealand make for uncomfortable companions. We enjoy largely unpolluted skies and outdoor lifestyles, but at a cost: the country has extremely high rates of skin cancer, one of our most common cancer types. Despite years of warnings about the risks of unprotected exposure to the sun, New Zealand still has a distressingly high rate of melanoma. The deadly skin cancer kills around 270 New Zealanders a year.

A new Queensland study should make policymakers question whether New Zealand is doing enough to prevent skin cancers from claiming so many lives or imposing costs on the health system. The study found that New Zealand melanoma rates have almost doubled over the last three decades - from about 26 cases per 100,000 people in 1982 to about 50 cases per 100,000 in 2011. While Australia's melanoma rates have been declining since 2005, New Zealand's rates are increasing and will not ease - and then only slightly - until next year.

Sadly, for many older, fair-skinned New Zealanders, the damage already has been done. As the country's population ages, the number of melanomas diagnosed will continue to increase, many decades after the cancer-causing exposure to sunlight occurred.

Researchers predict that New Zealand's melanoma rates will be about 46 cases per 100,000 people by 2031. Across the Tasman, rates in sunburnt Australia are expected to keep falling to about 41 cases per 100,000 people by 2031.

Treatment costs individuals and the community, as the push to add the expensive melanoma drug Keytruda to the list of funded medicines has shown. The medical community, however, maintains that skin cancer prevention initiatives are cost effective and an important public health investment.

The problem is they seem hard to implement.

Experts have explanations for this state of affairs. Associate Professor Tony Reeder of the Department of Preventive and Social Medicine at the University of Otago says New Zealand has failed to invest adequately in skin cancer prevention. He believes that unless the funds can be found then more New Zealanders than Australians will continue to develop potentially preventable skin cancers.

Dr Reeder is critical of the failure to ban sunbeds in New Zealand, noting that Australia - like Brazil before it - has closed the commercial tanning industry. A push to follow suit here failed last year when a Government majority on Parliament's health committee limited the ban to under-18-year-olds. The industry had argued that outlawing clinics would push sunbeds into the unregulated home environment. It is hard not to conclude that the committee could have adopted a tougher line.

A novel project in Dunedin carried out last summer reveals that families and schools could be doing a lot more to encourage sun-protective practices. Researchers who unobtrusively observed secondary pupils at their sports days found just 3 per cent of the students wore sun hats while waiting for their event. Among supervisors, only one in four wore a hat. Little shade was available for shelter from the summer sun, though half the schools sensibly provided sunscreen.

These results matter because skin cancers are linked with excessive exposure to ultra-violet radiation. The time when school sports occur coincides with the hours when the sun's most harmful trays are at their peak.

Dr Reeder says schools need sun protection policies to create an environment where students and staff can be safe in the sun. Simple rules and advice might help young New Zealanders avoid the fate which awaits too many older Kiwis.

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