SunSmart could have contributed to a recent reduction in melanoma among residents of Australia. The findings of the new study may have implications for the future delivery of skin cancer prevention programs.

But measures previously used to monitor change over time in preventive behavior for this population focused on just single sun protection behaviors, omitting the effect of extent of use of both individual and combined behaviors that reduce exposure to ultraviolet radiation.
This may have led to underestimates of behavior change, given that effective sun protection involves multiple strategies including sun avoidance. To address this issue, Dobbinson and colleagues conducted a population-based survey in Melbourne in the summer before SunSmart commenced (1987-88) and across summers in three subsequent decades (1988-2017).
During summer months, residents ranging in age from 14 to 69 years were recruited to participate in weekly telephone interviews assessing their tanning attitudes, sun protection behavior and sunburn incidence on the weekend prior to the interview.
By analyzing trends in sun protection behavior for 13,285 respondents, the researchers found that the use of sun protection increased rapidly in the decade after SunSmart commenced. The likelihood of using one or more sun protection behaviors on summer weekends was three times higher in the 1990s than before SunSmart (AOR: 3.04, 95% CI: 2.52-3.68, p <0.001).
There was a smaller increase in the use of maximal sun protection including shade (AOR: 1.68, 95% CI: 1.44-1.97, p <0.001). These improvements were sustained into the 2000s and continued to increase in the 2010s.
Although definitive evidence of the impact of the SunSmart program on skin cancer rates remains elusive, prevention programs should be supported given that lifelong protection is beneficial in reducing the risk of skin cancer.
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