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Skin Cancer Prevention Framework 2013–2017

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Skin Cancer Prevention Framework 2013–2017 Skin cancer prevention framework 2013–2017 Skin cancer prevention framework 2013–2017 If you would like to receive this publication in an accessible format, please phone 9096 0399 using the National Relay Service 13 36 77 if required, or email: [email protected] This document is available as a PDF on the internet at: www.health.vic.gov.au © Copyright, State of Victoria, Department of Health, 2012 This publication is copyright, no part may be reproduced by any process except in accordance with the provisions of the Copyright Act 1968. Authorised and published by the Victorian Government, 50 Lonsdale St, Melbourne. Except where otherwise indicated, the images in this publication show models and illustrative settings only, and do not necessarily depict actual services, facilities or recipients of services. December 2012 (1212003) Print managed by Finsbury Green. Printed on sustainable paper. Foreword Keeping Victorians as well as they can be is important for individuals, families and the community. It is also crucial for a strong economy and a healthy, productive workforce. Skin cancer is a significant burden not only on the Victorian community, but also nationally. Australia has the highest age-standardised incidence of melanoma in the world (Australian Institute of Health and Welfare 2010b). It is the most common form of cancer, with two in three Australians being diagnosed with the disease before the age of 70 (Stiller 2007). Of all cancers, skin cancer represents one of the most significant cost burdens on our health system and is one of the most preventable cancers. Victoria is a leader in skin cancer prevention, achieved through world class research, the innovative and internationally recognised SunSmart program, and policy and legislation reform. However, current skin cancer prevention activity in Victoria is fragmented and there has never been an overarching policy to guide effective, productive and sustainable activity. Better health outcomes can be achieved if a more systematic and comprehensive approach to skin cancer prevention is taken. Responding to this complex situation goes beyond the capacity of any one organisation. It demands whole-of-government and whole-of-sector approaches. This framework outlines how the Victorian Government will coordinate an effective and sustainable approach for government and the not-for-profit and private sectors to skin cancer prevention over the next five years. It is recognised within this framework that a balance is required between the risks of skin cancer from too much sun exposure and the benefits of spending time outdoors keeping physically active as part of a healthy lifestyle. This framework is guided by and aligned with two key government policy frameworks. The framework aligns with several of the outcomes articulated in the Victorian Health Priorities Framework 2012–2022 (Department of Health 2011a) and its approach to long-term planning and development priorities for Victoria’s health system. The Victorian Public Health and Wellbeing Plan 2011–2015 (Department of Health 2011b) states that the government will explore a comprehensive approach to skin cancer prevention, including evidence-based approaches for children, adolescents and young adults and other priority populations. This framework is working towards achieving this. Consultation with the government, the health sector, private sector and wider community has been essential in the development of this framework. I wish to thank all those community members, organisations and health professionals who contributed to the preparation of this document. Their advice and input shaped this framework and will guide its implementation. As the Minister for Health, l look forward to working together with government, the not-for-profit and private sectors in improving Victoria’s efforts in preventing the burden of skin cancer on our community. The Hon. David Davis MP Minister for Health Contents Foreword Overview 1 1. Background 4 Burden of disease 4 The cost of treating skin cancer 5 The cost-effectiveness of skin cancer prevention programs 5 Vitamin D 5 Policy context 6 Legislative and regulatory context 7 2. Scope 8 Partnership opportunities 9 Settings 12 Target groups 13 3. Strategic directions 14 Supportive environments for UVR protection 14 Knowledge, attitudes and behaviours 19 Early detection 21 Research and evaluation 24 4. Governance and reporting arrangements 26 References 27 Overview The strategic directions outlined in this framework will The framework has a strong focus on protecting young guide an effective and sustainable approach for skin people. Childhood and adolescence are critical periods cancer prevention over the next five years. This framework during which exposure to UVR is more likely to contribute takes a whole-of-government, whole-of-system approach. to skin cancer in later life (Stiller 2007). While reducing over-exposure to the sun will be effective in reducing skin Consultation has been at the centre of the framework’s cancer risk at any age, instilling good sun protective habits development. It was of great importance to the Victorian at an early age and reducing childhood over-exposure Government to consult widely with the health sector remains a priority. and the broader community in the development of this framework. In 2009, the Department of Health This framework outlines a number of strategies to protect commissioned an environmental scan that analysed young people from harmful over-exposure to UVR, ultraviolet radiation (UVR) protection activity in Victoria. focusing on the settings where they live, learn, work and The scan focused on early childhood, primary and play, including shade development, policy and improving secondary education settings; workplace settings; sun protection knowledge, attitudes and behaviours. adolescents and young adults; solaria; the built and It has been identified throughout the development of this natural environments; health promotion and public framework that the use of sunbeds is continuing to put health campaigns; and vitamin D. Within each of these young Victorians at risk. The risk of cutaneous melanoma settings the key stakeholders were listed, scoped work increases by 87 per cent when the use of tanning devices was documented and analysed, and challenges and starts before the age of 35 (Boniol et al. 2012). One in opportunities were discussed. The report from this six melanomas in Australians aged 18 to 29 years could environmental scan was presented as a background paper be prevented if solaria were closed (Cust et al. 2011). to guide and inform the development of the framework. With the increasing amount of evidence that sunbeds Two workshops were held in June 2010 and June 2011 are dangerous and putting young lives at risk, including with key partners and stakeholders. Alongside these a letter signed by 161 dermatologists, cancer specialists workshops, the Department of Health conducted a and clinicians, this framework outlines the government’s number of individual consultation meetings and interviews. plan to ban commercial solaria in Victoria effective from A public consultation on a draft framework was conducted 31 December 2014. It also outlines the government’s between 24 July and 30 September 2012 and a total of intention to seek to work with the Commonwealth 211 written submissions were received from organisations, and other jurisdictions to investigate the potential individuals and businesses. These submissions were options for a coordinated national approach on solaria, essential in refining this framework and ensuring it is including consideration of a ban on the importation and responsive to the needs of Victorians today. manufacturing of sunbeds. The actions outlined in this framework have been informed The framework also addresses the need to balance the by evidence and through extensive consultation with risks of skin cancer from too much sun exposure with the Victorian health sector and community. Overall, this maintaining adequate vitamin D levels. The sun’s UVR is framework’s goal is to reduce the incidence of, and both a major cause of skin cancer and the best natural mortality from, skin cancer in Victoria. This is a long-term source of vitamin D. The Victorian Health Monitor found goal that will take many years to achieve. This framework that one in 10 Victorian adults had a moderate to severe establishes ways the government, in partnership with the Vitamin D deficiency, three in 10 adults had a mild deficiency health sector, private sector and local communities, will and six in 10 had optimal or above optimal Vitamin D levels approach this task over the next five years. (Department of Health 2012). Vitamin D is an important consideration when implementing any skin cancer prevention policy or activity in Victoria and will be considered for each of the priorities outlined in the framework. 1 This framework is structured in four sections. The overall • Strengthen Victoria’s skilled workforce to better structure of the framework is provided in Figure 1. recognise, treat and refer skin cancers across the healthcare continuum. Section 1 sets the background for the framework. It outlines the case for change, including the significant • Promote appropriate and high-quality surveillance and burden of skin cancer on the Victorian community, the cost monitoring options for those individuals at most risk. to the health system in treating skin cancer and the cost- • Advocate to the Commonwealth Government to review effectiveness
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