Messages should emphasise the need to cover up and stay out of the sun

Health promotion strategies to prevent deaths from skin cancer, particularly melanoma, have two components: advice on early recognition and advice on prevention. The population is perhaps heeding advice on early recognition. Five year survival from melanoma in England and Wales is improving, particularly in female patients,1 probably because the cancer is diagnosed at an earlier stage owing to increased public awareness. But the incidence of melanoma is increasing in the United Kingdom and the United States; 1 2 in the United Kingdom it has doubled over the past 20 years.1 This contrasts with a falling incidence in Australia,3 but it is not clear whether this difference is attributable to the Australian prevention campaign having been active for longer or whether prevention messages are less effective in the United Kingdom. By 1996, attitudes among Australian students had already shifted positively towards avoiding exposure to the sun and away from the use of sunscreen and desire for a tan.4 In contrast, a study of 80 students in the United Kingdom published in 2000 found that most emphasised positive benefits of sun exposure, enjoyed sunbathing, protected themselves inadequately, and did not intend to change this behaviour.5

Experts believe that 90% of non-melanoma skin cancers and two …