Appendix 4: Other considerations

The primary purpose of the Strategy is to address the skin cancer risks for individuals in NSW due to overexposure to UVR through primary prevention measures.

To this end the Strategy does not include activities for addressing issues associated with the community’s requirements for vitamin D synthesis for good health, or the early diagnosis of skin cancers for reduced mortality.

Vitamin D

Solar UVR is both the major cause of skin cancer and the best source of vitamin D. There is no single universal recommendation around adequate levels of sun exposure for meeting vitamin D3 requirements.28

Appropriate UVR protection does not put people at risk of vitamin D deficiency. Balancing messages about the risk of skin cancer from too much sun exposure with maintaining adequate vitamin D levels has been and remains a challenge for skin cancer prevention programs in NSW, Australia and in other countries.

This issue may be explored further in conjunction with activities in the Strategy, such as the consistency of skin cancer prevention messages.

Early diagnosis

Melanomas that are less than 1mm thick rarely threaten life. Survival after a diagnosis of melanoma decreases, however, with increasing melanoma thickness.

To reduce mortality, knowledge about skin changes that may indicate development of melanoma and characteristics associated with melanoma depth is needed.

In 2008 the Australian Cancer Network Melanoma Guidelines Revision Working Party released the report, Clinical Practice Guidelines for the Management of Melanoma in Australia and New Zealand.29

These guidelines report that early diagnosis of melanoma is essential and that skin screening, defined as a visual inspection of the whole body, may be one method of achieving it.

There is, however, very limited evidence to support the value of skin screening. As more evidence is required to assess the optimal approach to guidelines for skin cancer screening, the identification of specific activities for early diagnosis of skin cancer has not been included in this Strategy.

Enhancing the role of the primary care sector in cancer control is a goal of the NSW Cancer Plan and a range of activities have been outlined by the NSW Cancer Plan for achieving this.