The battle to beat skin cancer is now being fought in the prams, pushchairs and pre-schools of Queensland.
Mothers and babies are the focus for the latest study by the Centre for Health Promotion and Cancer Prevention Research, at the University of Queensland's Department of Social and Preventive Medicine.
Previous awareness and prevention campaigns have targeted parents and older children; for example, the Centre has just published a sun safety resource aimed at youngsters aged 12 to 14, before which another was designed for primary schools.
Now attention is turning to mothers and infants from birth to age four in a three-year, $180,000 project funded by the National Health and Medical Research Council and led by centre director, Associate Professor John Lowe.
Dr Lowe said the centre's work addressed all forms of cancer but in Queensland there was special emphasis on breast cancer, smoking-related cancer and - significantly for the Sunshine State - skin cancer.
"Our primary aim with skin cancer is prevention by reducing exposure to the sun. At a secondary level we encourage early detection since this is a form of cancer which in very many cases is treatable and curable," Dr Lowe said.
For the latest study of mothers and babies, 300 women acting just on general information will be compared to 300 others following the centre's special program which the mothers themselves helped design.
Dr Lowe said data collected so far showed most mothers protect their children from the sun very well up to the age of one. "However, we know that from the ages of one to four, as the children become more vocal and mobile, then sun protection becomes less of a priority," he said.
"They rip off hats, refuse sun screen, won't stay in the shade and so on. For the chief care-giver, usually the mother, doing the right thing to protect the child suddenly takes a lot more planning and preparation.
"Also about this time the child starts to see the parent as a role model. That's why in this program we want mums to do the right things for themselves and their children.
"We'll be looking at how children are protected through the use of sun screen and clothing, whether mothers remember such items on trips and outings, and levels of support from family members and other mums," Dr Lowe said.
In a parallel study at the centre, PhD student David O'Riordan, supervised by principal research fellow Dr Warren Stanton, has so far spent a year looking at the amount of sun exposure in children up to the age of five.
This research, described by Dr Stanton as a "unique study of infant sun exposure", is also examining parental behaviour in terms of providing sun protection for children.
As part of the data collection process, subjects have been wearing UV radiation measuring devices while mothers have also been keeping diaries, filling in questionnaires and taking part in discussions.
The study will focus on several protective measures - shade, clothing, hats and sun cream - to see which mothers use for themselves and their children, and compare behaviour patterns in summer and winter.
Mr O'Riordan said general findings to date suggested that as children grew older they spent more time in the sun, were less well protected and got more potentially harmful exposure.
Dr Stanton said one alarming statistic to emerge was that most young children were sunburnt at least once by the age of three. He said given the cumulative effects of sunburn as a known cause of skin cancer, the aim had to be nil sunburns.
Australia had one of the highest rates of malignant melanoma in the world and Queensland one of the highest rates in Australia, Dr Lowe said. The disease had killed a child as young as nine though the most vulnerable group was men over the age of 50.
"Melanoma is a major killer among cancers. And since exposure to the sun at an early age is a known risk factor, being born in Queensland unfortunately becomes a big risk factor," he said.
Preliminary data from the Australian Bureau of Statistics shows that in 1996 there were 1281 deaths from skin cancer in Australia (240 of them in Queensland), 2642 from breast cancer, 4618 from bowel cancer and 6826 from lung cancer.
"We know the sun causes skin cancer but we still don't know exactly how. Being burnt by the sun is certainly a major contributing factor so our aim is not so much to keep people out of the sun as to warn them against being burnt," Dr Lowe said.
"However, the best way to avoid burning is to keep covered up, wear sun screen or stay in the shade - or all three. Even if you don't get skin cancer, the sun still causes premature aging of the skin and makes people look older.
"We are trying to change people's attitudes and foster the idea that you don't need a tan to look good. That message is slowly being accepted and certainly people are less attracted to deep tans than they used to be."
The primary site of melanoma can be a tiny spot on the skin surface. However, it is the depth of the tumour which is critical and enables the cancer to spread to other parts of the body, usually to the lymph nodes and liver.
However, while malignant melanoma is the most serious type of skin cancer it is also the least common. There are two other types also caused by sunlight and it is estimated that about 150,000 such cases are diagnosed in Australia each year, the vast majority being successfully treated.
For further information, contact Dr John Lowe (telephone 3365 5505) email: j.lowe@mailbox.uq.edu.au or Dr Warren Stanton (telephone 3365 5512).
