Children spend a substantial amount of time outdoors and it has been estimated that, on average, over half the lifetime dose of ultraviolet (UV) radiation is received by the time a person reaches 20 years of age. There is a strong link between an individual’s total lifetime UV exposure and the development of skin cancer, particularly squamous cell and basal cell carcinomas, the two most common forms of skin cancer.
Even more significant is the emerging association between the number of extreme sunburn incidents in childhood and the risk of melanoma, the most fatal form of skin cancer, later in life. The skin of babies and young children is undergoing development and can be very sensitive to UV radiation; as a result, a child's skin may burn easily. For these reasons, sun safety in children is particularly important. Unsurprisingly, research shows that children whose parents demonstrate sun safe practices are more likely to imitate such behaviour.
Skin cancer in children
Skin cancer in childhood is relatively rare. A study spanning 23 years of melanoma incidence in the U.S. showed that only 1.3% of cases reported were in children or adolescents (a higher proportion were female). Unlike the adult and teen populations, the rate of skin cancer in children is not increasing.
Australia has among the highest rates of skin cancer in the world. In response to this trend, comprehensive health education about the sun has been implemented in Australian schools. A 1997 study comparing European and Australian school children revealed that the European children were less aware of the dangers of sun exposure and the importance of skin UV/sun protection. The Australian children also had a better understanding of the benefit of combining several methods of sun protection (i.e. sunscreen, clothing, hats and shade) and, on average, valued suntans less than the European children.
Skin cancer in teenagers
Melanoma, the deadliest form of skin cancer, is the most common type of cancer in young Australians aged 12-24 years. Fortunately, its prevalence in Australian teenagers is decreasing; perhaps as a result of skin cancer awareness campaigns and school/public education programs relating to sun protection. According to several studies, the strongest predictor of melanoma risk is solar UV exposure during childhood and adolescence; particularly the incidence of severe sunburns at this age. The 2003-2004 National Sun Survey revealed that on an average weekend 25% of Australians aged 12-17 years got sunburnt. This is, for a large part, due to their reluctance to implement sun protection, with only 37% applying sunscreen. The reasons given for these behaviours include: a lack of motivation; forgetfulness and self-consciousness about image.
Parents and guardians can promote healthy habits by modeling sun safe behaviours: wearing hats, sunscreen and protective clothing and avoiding sun at periods of the day when it is at its most intense. Regular reminders and having hats/sunscreen readily accessible may also provide incentive. Allowing a choice of style of hats and protective clothing can help alleviate concerns regarding personal style and may make some teens more amenable to covering up. It is also beneficial to encourage regular skin checks for changes in moles and freckles, as this increases the likelihood of prompt skin cancer detection, which is more treatable in its early stages. Finally, discussing the consequences of sun damage such as photoaging (wrinkled skin) and skin cancer may further help to motivate self-protection in teenagers.
Hamre, MR et al. 2002, ‘Cutaneous melanoma in Childhood and adolescence’, Pediatric Hematology and Oncology, 19(5):309-317.
Children’s Hospital Boston n.d, ‘Skin Cancer’, retrieved 26 July 2010, http://www.childrenshospital.org/az/Site1603/mainpageS1603P0.html>.
Newton Bishop, JA 1997, ‘What do children aged 5 to 11 years old know about the sun and skin cancer? The practical difficulties of international collaborative research when analysis of language is involved’, Melanoma Research, 7(5):428-435.