But despite better awareness, in Australia melanoma is still the most common cancer among 15 to 39-year-olds. Every year, over 14,000 are diagnosed and two out of three people in the Oceanic country will end up with skin cancer in their lifetime. More than 50 per cent of Australian adults will have had at least one skin cancer by the age of 50, according to John Thompson, an emeritus professor of melanoma and surgical oncology, The University of Sydney.
“It’s a complicated story,” says Prof Thompson. “There’s an epidemic of melanoma in older males in particular which reflects attitudes to sun care decades ago.”
Today in Australia, awareness of sun damage and UV protection begins in primary school and continues through to high school. Youngsters at primary school can’t go out to play without a hat, while playgrounds and sports venues are designed with covered shady areas.
“Parents are very aware of the risk to younger children,” says Prof Thompson. “From the moment they are born, children are protected and that continues through kindergarten and school. Workplaces are also very aware — some provide containers of sunscreen and outdoor workers are encouraged to use it and wear protective clothing, such as hats and long-sleeved shirts.”
Employers are held liable, and many have been sued by workers who develop melanoma from outdoor working and haven’t been offered appropriate sun protection.
In Australia, sun safe messaging has been part of the public health landscape since the Eighties — when the Slip, Slop, Slap campaign was launched, advising citizens to slip on a shirt, slop on sunblock, and slap on a sun hat.
Vigilance was ramped up again in 1987 after the broadcast of a three-part television documentary, Goodbye Sunshine, about a young man dying of melanoma. In the three months after broadcast there was a 167 per cent increase in the number of melanomas diagnosed compared with the same period the year before. More recently, the country has banned sunbeds.
Despite all the public messaging, Australia still tops the global list for skin cancer, although rates are flattening. This is partly because, as Prof Thompson says, “people get to their teens and early adulthood, leave school and think they are invincible”. The attraction of the tan in a nation of beaches is just too much for many.
Jay Allen is trying to change that.
In 2008, at the age of 32, Allen was diagnosed with stage 3 melanoma. In January 2021, after being cancer-free for over 12 years, he found a golf ball-sized lump on the right side of his neck. This was diagnosed as a squamous cell carcinoma, for which Allen underwent radiation and chemotherapy. This month, he was given the all-clear.
Allen is the chief executive and founder of the Australian Skin Cancer Foundation, which he founded in 2021 to raise awareness and provide advocacy education and support. It operates a mobile free skin cancer screening service. On the side of the NGO’s skin check truck are photos of over 80 friends Allen has met through his work who have died because of melanoma.
Nurses on the truck see up to 200 people a day and queues for the service form in car parks ahead of its arrival. So far, they’ve checked over 7000 people in 52 locations. The service has found over 32 melanomas, over 600 basal cell carcinomas, and over 700 squamous cell carcinomas.
Allen has just finished a 13-day tour of Queensland where melanoma rates are the highest in the world.
By his reckoning around 40 per cent of the population in Australia are careful and recognise the risks, “but the other 60 per cent are still tanning and not getting regular skin checks”.
“It’s part of the culture over here to get a tan and look good. We’ve got to try and change that. In kindergarten and primary school there is lots of education but then it all falls apart at high school.”