CIESIN Thematic Guides

Prevention and Treatment of Skin Cancer due to Ultraviolet-B Radiation Exposure

Strong evidence exists of a dose-response relationship between nonmelanoma skin cancer and cumulative exposure to UV-B radiation. Increased risk of malignant melanoma is associated with episodes of acute exposure that result in severe sunburns, especially those that occur during childhood. In general, the incidence of nonmelanoma and malignant melanoma skin cancer have significantly increased over the past few decades, particularly in the United States, Canada, Australia, the United Kingdom, and Scandinavian countries. Researchers are examining the relationship of the growing risk of skin cancer to increases in ground-level UV-B radiation due to ozone depletion. Behavioral changes, such as the popularity of sunbathing, over this time period are also considered key risk factors. In the past behavioral changes may have been the primary reason for the rising incidence of skin cancer; however, given the current trend in outdoor activities, increases in ground-level UV-B radiation may raise exposure levels even higher resulting in an even greater risk of skin cancer. Early detection and appropriate treatment have stabilized and perhaps even lowered mortality rates from skin cancer. The focus is now on educational programs to convince susceptible populations to reduce their risk of skin cancer by adopting preventive measures and avoiding harmful exposures.

Bentham, in the 1993 paper "Depletion of the Ozone Layer: Consequences for Non-Infectious Human Diseases," and van der Leun and de Gruijl (1993), in the chapter "Influences of Ozone Depletion on Human and Animal Health" of UV-B Radiation and Ozone Depletion, voice a common concern: Given the strong association between ultraviolet radiation exposure and skin cancer, the anticipated rise in UV-B irradiance due to ozone depletion may significantly increase the risk in exposed populations. Several researchers, including physicians Robinson (1990) and Stern, Weinstein, and Baker (1986) suggest policymakers, health care professionals, and individuals adopt measures to prevent and treat future cases of skin cancer. In "Risk Reduction for Nonmelanoma Skin Cancer with Childhood Sunscreen Use," Stern, Weinstein, and Baker (1986) recommend that pediatricians prescribe sunscreen use and sun avoidance as a routine aspect of pediatric preventive health care. In "Behavior Modification Obtained by Sun Protection Education Coupled with Removal of a Skin Cancer," Robinson (1990) describes the behavior modification and compliance with sun-protection measures of more than 1,000 patients over the age of 20 during a four-year period. Prawer (1991), also a physician, strongly suggests in "Sun-related Skin Diseases" that all patients be counseled on the harmful effects of all sources of UV radiation and educated about methods of photo-protection. The global scope of this problem, the severity of its effects, and the low cost of prevention all seem to warrant widespread public education among high risk populations.