Contents of The Skin Cancer Foundation Journal - MAY 2012

The 2012 edition of The Skin Cancer Foundation Journal features medically reviewed, reader-friendly articles such as tanning, the increasing incidence of skin cancer diagnoses among young women, & the prevalence of melanoma among white males over 50.

Page 43 of 103

LIFESTYLE
limited evidence though high-level. We would like to see the study replicated in another population. Our numbers were sizable, but not as big as in some longer-running cancer studies. Currently there's no firm evidence
that BCC is preventable by sunscreen; there's no trial evidence that I know of.
Q: What was different about your recent study on sunscreen and melanoma prevention that made the evidence more definitive than previous research? Why wasn't this kind of study done before? A: Well, it wasn't for lack of trying! People wanted to do it, but carrying out a study of this size is daunting. However, being in Australia helped: Australia has the world's highest rate of melanoma, so it wasn't as difficult to accrue in one study sufficient numbers of melanoma-affected individuals as it would be in most other places.
Control Group Continued using (or not
using) sunscreen as they always had
But it still was not easy! Not as 'easy'
as a case-control study, for example, which retrospectively compares the habits and exposures of a group of people with a particular condition or disease to the habits and exposures of a control group of study participants who do not have that condition. Yes, many case-control studies had inves- tigated the issue of past sunscreen use and melanoma prevention. The biggest difference from all these previous sunscreen and melanoma studies was that in our study all participants were randomly assigned to either the intervention group — whom the researchers advised in using freely- provided sunscreen — or to the control group, who were asked simply to continue their regular patterns of sunscreen use. In a normal case-control study,
we gather existing data rather than actively intervene. In contrast, we
Treated Group Provided with sunscreen,
and given careful instruction and supervision in daily sunscreen application
gave our intervention group sunscreen along with little cartoons to show them exactly what they needed to do in terms of application, and every three months we reinforced this by replenishing sunscreen supplies. The trial began in 1992, and all together, people used the study sunscreen for four-and-a-half years until 1996. In 1997, we started a 10-year follow-up study. Intervening in people's lives is challenging
naturally more than
simply observing people doing what they normally do. Remember, our participants weren't patients, they were people simply living in the com- munity. In a study like this, you need to take time to establish good rapport; our community participants were generous and committed to helping in medical research, since we asked quite a lot of them. On the other hand, our trial could not be a traditional controlled trial, in
1,600 Length of study
22 11
42
Number of participants 15 years
Number of melanomas developed in the Control Group
Number of melanomas developed in the Treated Group
LEGEND = melanomas developed
SK IN CANCER FOUNDAT ION JOURNA L