Childhood Cancer Prevention in Australia - Research Paper Example

Skin Cancer in Australia Contents Introduction 2.Overview 3. Rationale for this health issue as a NHPA 4. Intervention 5. Conclusion References 1.Introduction Australia is a very sunny country in the main. This can mean that its citizens are at times over exposed to sunlight and the harmful ultra violet rays this contains. According to the National Health Priority Areas ( 2013) Cancer Prevention plans were put in place in 1996. According to statistics put forward by the Cancer Prevention Plan, in 2009, one in two Australian males will at some point be diagnosed with cancer and 1 in 14 will suffer from skin cancer. Among women the risk is slightly less at 1 in 14 being affected. The Cancer Council Australia (Be Sun smart 2013) gives figures of more than 434,000 Australian people being treated for one or more non-melanoma cancers every year and, in the case of melanomas, 11,500 people require treatment annually. According to Right Diagnosis (2014) skin cancer is recorded as the tenth most common cause of deaths from cancer within Australia. These cancers also account for roughly 80% of all newly diagnosed Australian cancers ( Cancer Council of Australia 2014). Despite advances made in recent years, skin cancers are still being caused as a result of skin damage by the sun, and so are preventable. There are three types of skin cancer, melanoma, squamous cell carcinoma and basal cell carcinoma, and of these the first , melanoma, is the most aggressive and dangerous ( University of Michigan Health System , 2013). As well as affecting many lives in negative ways , it also increase costs for the health services, as well as using up many resources, so adequate prevention is a positive intervention. According to the University of Michigan report ( 2013) very young children are at much more risk than older people . For this reason this report will concentrate upon cancer prevention in children. In 1996 the first ever International Conference on Health Promotion, took place in Ottawa, Canada, on the 21st November ( WHO 2014). The conference advocated income, sustainable resources, peace, shelter, education, food, social justice, a stable eco-system and equity. The prevention of childhood skin cancers would fit into this, as prevention programmes must be available to all affected equally as an act of social justice. Income to pay for any strategy is needed , as is education on the topic, and the provision of sustainable resources, and even shelter from the sun’s rays. This paper will therefore consider childhood cancer and its prevention in Australia. 2. Overview According to Slowik ( 2012) ultra violet rays (UV rays) are part of the section of sun light hidden to normal human view. Over exposure to UV rays can cause damage to DNA, the genetic material contained in the body’s cells. In the skin cells these genes control the ways in which skin cells grow and their health. Norby ( undated) refers to thyamine dimers which are a pair of adjacent thymine bases in DNA which have chemically bonded in an abnormal ways, and this abnormal bonding is the result of damage caused by ultra-violet irradiation. The cellular processes that could repair these lesions often, in error, create genetic mutations (Lefers, 2004) . If the genetic damage becomes severe, then previously normal skin cells can begin to grow in a disorderly way as a cancer. Cochrane (2014) was able to show how these then spread the cancer via the lymphatic system. Cochrane (2014) also goes on to describe how early treatment, before the cancer has thickened, can be related to the effectiveness of treatments in managing nodal tumours and other metastases. The research described shows that patients who had primary melanoma tumours of only intermediate thickness (1.20 to 3.5 millimeters) had a higher survival rate than others with thicker initial tumours. Slowik ( 2012) describes two types of UV rays, both A and B and the way in which can stimulate the origins of skin cancers. He states that at one time it was thought that it was only UV B which could cause skin cancer, but more recent research has shown that both types can be involved. For this reason those likely to be exposed need to know that sun protection creams and spray need to protect against both types, A and B. He also points out that there can be a genetic component to these diseases which may be hereditary within families. In such cases the skin cancer is caused by the inheritance of abnormal genes passed from parent to child. This genetic component seems to be backed up by statistics, as stated by Kim et al ( 2009) which show clear differences in rates of skin cancers among men and women, and among Chinese, Malays and Asian Indian people. The Australian Indigenous Health Info.net (2013) does not specifically deal with skin cancer, but shows that aboriginal people are statistically less likely to develop cancers than non-indigenous people, although it is admitted that under reporting, or incorrect reporting of causes of death, may contribute to these statistical differences. Within Australia the government of New South Wales has described skin cancer as being Australia’s national cancer, with the highest rate of melanoma in the world in men and the second highest rate in women. Statistics show that cancer of the skin is the most common cancer in young Australians people aged between their mid- teens and 39 years in NSW. (NSW Cancer Institute, 2014 ). 3.Rationale for this health issue as a NHPA Anyone can get skin cancer, but within New South Wales the stress has been upon groups considered to be the most vulnerable these being very young children, students at schools and colleges and adult men, especially those who work out of doors (The New South Wales Skin Cancer Prevention Strategy 2012-2015) . Norby ( undated) describes how Australians are especially vulnerable because the country has a combination of a majority of fair skinned inhabitants, a preponderance for out-door activities, especially in childhood which is a very vulnerable time. These factors work together with the country’s tropical position , which means even greater amounts of exposure to a high degree of ambient ultraviolet radiation. According to the Cancer Council of Australia (2014) there is evidence which would suggests that sun exposure in early childhood can make a significant increase in a person’s lifetime risk of skin cancer, and for this reason they recommend keeping children out of the sun as much as is possible, especially during their first year. According to the University of Michigan research has shown have shown that the majority of people have about 80 percent of their life time exposure to ultra violet rays before they reach the age 18. This exposure could cause damage which is both permanent, and which accumulates over time. According to Mann ( 2014) writing about the risk in the United States, there has been a 2% rise in melanomas found in white children every year from 1973 to 2009, so this is an increasingly serious problem, but it should also be remembered that damage is often being done in early life which could produce these cancers later in life. Bloom, 2010, described how it is possible to identify those individuals at higher risk for melanoma by looking at links between the amount of sunlight to which the person is exposed, and how fair their skin is , and he investigated known genes that may play a part in the disease process of these growths. Statistics from Cancer Research UK ( 2014) show clearly how much more prevalent these cancers are in Australia as compared to many other countries. It has the highest rates in the world, more than twice as high as the next highest country, the United States of America, and far in excess of the remainder of the world, especially Asia. The same organisation ( Cancer Research UK, 2014) considered skin cancers among European countries, and in the main it was fair skinned Nordic peoples who had the highest rates of malignant melanomas as compared to those from further south and east in Europe. D’Orazia et al (2013)describe the UV radiation to which Australians are constantly exposed as being a :- "Complete carcinogen" because it is both a mutagen and a non-specific damaging agent and has properties of both a tumour initiator and a tumour promoter. They also point out that UV radiation can also be involved in the process of other skin conditions, but on the other hand point out that UV can be of benefit to human health by being the means of natural synthesis of vitamin D, and of endorphins in the layers of the skin. In a country such as Australia it might be assumed that the population will receive naturally enough sunlight to produce adequate levels of Vitamin D, but Nowson et al argued ( 2004) that this is not necessarily so, despite the fact that deficiency of this essential vitamin can be prevented by just 5-15 minutes exposure of just the face and arms to the sun 4-6 times per week. They are considering in particular people for whom absorption might be a problem , such as those with coeliac disease, but point out that, even for these supplements can be effective, without over exposure to UV rays. 4.0 Intervention In the Australian state of Victoria, and in Melbourne in particular, Dobbinson et al ( 2004 to the present) found that, among adolescents in Victorian schools, although the students were found to be aware of facts about skin cancer prevention messages, it was found that most Australian adolescents in this study still wanted to have a suntan, and also under-used sun protection methods such as sun screen creams and hats. Presumably it isn’t considered the done thing to slip, slap and slop ( Cancer Council Australia, 2013), or is it just that the original campaign was just too long ago, having been produced in 1980, so when their parents were growing up. The programme was however updated in 2007 with the added messages to seek and slide , that is to seek shade, which these young people did, and to slide on sunglasses, so these youngsters would be highly likely to have seen it. This controlled intervention study is long term, and considered the effects in 51 Melbourne secondary schools of building shade sails. The researchers wanted to find out whether students would use these sun shades or would built shade. It was found that a majority of students made use of the new sites with shade, as compared with other sites which had full-sun . The study found no evidence of deliberate shade avoidance by the young people. This intervention study clearly shows that if shade is provided it will be utilised, but also shows, that despite good knowledge, young people do not necessarily make the right choices with regard to skin protection from UV rays. This intervention can be linked, at least in part, to the WHO Health Impact Assessment and its determinants of health which it lists as the social and economic environment ; the physical environment, and also in individual’s personal characteristics and behaviours. The physical environment was altered by the provision of sail shade shelters and this affected behaviour, but at the same time the young people made their own decisions on the matter, and persisted in their underuse of sun screen and other types of protection. 5. Conclusion This report considers skin cancers, and especially melanomas, the most virulent form of skin cancer disease, and its causes and prevention. It looks at research into these conditions and the statistics as to its frequency, and the reasons for differences between various population groups, as well as between the sexes, as well as why this might be. It also looks at a possible intervention and the results of a long term study into the use of available shade by adolescent school students, as well as how this group, despite widespread knowledge about skin cancers in these students, continued to make their own decisions with regard to the use of sun screens and other methods of self -protection. Skin cancer is on the increase, and so dealing with it is an urgent matter for the people of Australia. In whatever form it takes, it is also to a large extent preventable, but the skin damage caused by over exposure to Ultra violet rays has been shown to be cumulative, with the greatest exposure in most cases, occurring in childhood. Although all vulnerable people need to be educated in skin cancer prevention, the young should particularly be targeted, as it is they who are in the most vulnerable position, and have a life time of Australian sun still to deal with. References Bloom,B.,(2010), Melanoma in Women Under age 50: Can genetics work with estrogen to boost risk? The Melanoma Letter, Volume 28, no.1, retrieved from http://www.skincancer.org/publications/the-melanoma-letter/spring-2010-vol-28-no-1/melanoma-in-women-under-age-50-can-genetics-work-with-estrogen-to-boost-risk Cancer Council Australia, (2013), Slip Slop Slap Seek Slide retrieved from http://www.cancer.org.au/preventing-cancer/sun-protection/campaigns-and-events/slip-slop-slap-seek-slide.html Cancer Council Australia,( 2013), Be SunSmart, retrieved from http://www.cancer.org.au/preventing-cancer/reduce-your-risk/be-sunsmart.html Cancer Council Australia, (2014), Skin Cancer, retrieved from http://www.cancer.org.au/about-cancer/types-of-cancer/skin-cancer.html Cancer Council of New South Wales, (2013), Our Research in to Skin Cancer, retrieved from http://www.cancercouncil.com.au/50443/cancer-information/cancer-research-cancer-type/latest-research/our-research-into-skin-cancer/ Cancer Prevention Plan, (2013), retrieved from http://www.aihw.gov.au/cancer/ Cancer Research UK.,( 2014), Skin cancer incidence statistics, retrieved from http://www.cancerresearchuk.org/cancer-info/cancerstats/types/skin/incidence/uk-skin-cancer-incidence-statistics#world Cochran, A., (2014), Long-term Research Confirms Game-Changing Method for Detecting Spread of Deadly Skin Cancer, retrieved from http://www.cancer.ucla.edu//Index.aspx?page=644&recordid=704 Dobbinson,S., Wakefield, M.,White,Vicky ,White Vanessa, Jamsen,K., Livingston, T., English, D., and Simpson,J., (2004 to present), Cluster randomised controlled trial of adolescents use of built shade in secondary schools, retrieved from http://www.cancervic.org.au/module_research/module_research_projects/adol-use-shade-sec-schools.html D’Orazia, J., Jarrett,S. , Amaro-Ortiz, A. and Scott,T.(2013), , UV Radiation and the Skin., retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23749111 Kim S, Takahashi H, Lin ,W., Descargues P, Grivennikov S, Kim Y, Luo J and Karin M. (2009) Carcinoma-produced factors activate myeloid cells through TLR2 to stimulate metastasis. Nature.;457 pp102–106 Lefers, M, (2004), Thymine Dimer, retrieved from http://groups.molbiosci.northwestern.edu/holmgren/Glossary/Definitions/Def-T/thymine_dimer.html Mann, D.,( 2014), Melanoma Rates Rising in U.S. Children: Deadly skin cancer still rare in kids, but long-term study found 2 percent yearly increase among whites, WebMd, retrieved from http://www.webmd.com/melanoma-skin-cancer/news/20130403/melanoma-rates-rising-in-us-children National Health Priority Areas, (2013), retrieved from http://www.aihw.gov.au/national-health-priority-areas/ Norby, K.,(undated), The sunburned country: skin cancer in Australia, http://www.biology.iastate.edu/InternationalTrips/1Australia/04papers/NorbySunburn.htm Nowson, C., Diamond T., Pasco J., Mason R., Sambrook P., and Eisman J. ,( 2010), Vitamin D in Australia: Issues and recommendations, Australian Family Physician, Mar;33(3): pages 133-8. NSW Cancer Institute, (2014), A United Front Against Cancer. retrieved from http://www.cancerinstitute.org.au/news-events/latest-news/a-united-front-against-skin-cancer Slowik, G. (2012), What Causes Skin Cancer? retrieved from http://ehealthmd.com/skin-cancer/what-causes-skin-cancer#axzz2zucqe3aY The Australian Indigenous Health Info.net (2013) Review of Cancer Among Indigenous People, retrieved from http://www.healthinfonet.ecu.edu.au/chronic-conditions/cancer/reviews/our-review#specific-cancers The New South Wales Skin Cancer Prevention Strategy( 2012-2015), retrieved from http://www.cancercouncil.com.au/wp-content/uploads/2010/09/2012-11-19_nsw-skin-cancer-prevention-strategy.pdf University of Michigan Health System ,( 2013) retrieved from http://www.cancer.med.umich.edu/cancertreat/skincancer/skin_cancer_prevention.shtml WHO, 2014, The Ottowa Charter for Health Promotion retrieved from http://www.who.int/healthpromotion/conferences/previous/ottawa/en/index4.html WHO Health Impact Assessment, (2014), The determinants of health, retrieved from http://www.who.int/hia/evidence/doh/en/ Read More