The landmark ComPARe study reaffirms that skin cancer is a major health issue in Canada, that requires strong efforts in prevention. Elementary and secondary schools are an important context for reducing this burden of skin cancer, alongside other settings. While it may take a while for schools to return to usual routines and develop new ones after closures due to COVID-19, we can aim to increase our school-based efforts in the coming years. In the spring, the warmer weather, a higher UV Index, and National Sun Awareness Week (May 11 to 17, 2020) can remind us of this long-term goal.
Skin cancer, which can be divided into melanoma and non-melanoma types, is the most common cancer in Canada and globally. Melanoma is much more likely than non-melanoma to be fatal. Non-melanoma skin cancers (mostly basal cell or squamous cell carcinomas) are rarely fatal, but they can be disfiguring, and they contribute to the high economic cost of skin cancers.
Skin cancer is largely preventable, since the main risk factor is exposure to ultraviolet radiation (UVR), usually from the sun or indoor tanning. As shown in the infographic below, the ComPARe study found that about 4,300 cases of melanoma in Canada in 2015 can be attributed to UVR, and that number is projected to increase to about 6,100 per year in 2042. For non-melanoma skin cancers, about 60,000 cases in 2015 can be attributed to UVR, and that number is projected to increase to over 132,000 per year in 2042. Most importantly, if more Canadians practised sun safety by 2037, then about 12,000 cases of melanoma and 322,000 cases of non-melanoma skin cancers could be prevented by 2042.
Although skin cancer in childhood and adolescence is uncommon, being overexposed to UVR during this period increases the risk for skin cancer in adulthood. School-based prevention may therefore be crucial, since children and youth are at school when the UV Index is highest during the day, and there can be many opportunities to learn about sun safety routines. School-based approaches can also reinforce approaches for other key settings for this age group, such as outdoor camps and family life.
Canadian and international experience and evidence in school-based approaches show many creative possibilities that we can learn from and potentially adopt or continue. At the classroom level, these include teaching tools such as songs, videos, or simulations of students’ faces with UVR damage. At the school level, these include scheduling outdoor activities when the UV Index is lower, hat policies, installing shade structures or planting trees, youth and family engagement, comprehensive approaches, and others. School board and government policies can also be created or strengthened in various ways, for example by requiring schools to implement some of these measures.
We’ve seen some great school-based campaigns and programs in Canada. For example, the Canadian Cancer Society continues to offer a primarily school-based SunSense program in several provinces (such as New Brunswick and Ontario), and it can address multiple aspects of the school setting.
Let’s aim to build up our school-based skin cancer prevention approaches during the coming years. The ComPARe study results can be valuable for increasing momentum for this work.
Max Carynnyk, MPH
PhD Student, Department of Population Medicine
University of Guelph
Thanks to Dylan O’Sullivan for his input on the data summarized above.