Skin cancer cases are rising. Here's what we can do about it

Recent reports suggest skin cancer rates are rising. The harmful effects of the UV radiation in sunlight, and emitted by tanning beds, are well established – UV damages the DNA in skin cells, leading to errors as these cells replicate and grow.

But we’ve been warned for decades about the dangers of spending too much time in the Sun or on sunbeds. So why is the message not sinking in?

Whilst recent news has focused on the UK, Dr Zoë Venables, NHS England Clinical Associate Professor and Dermatology Lead, confirms that the uptick in diagnoses is more widespread than that.

“Across the UK and globally, skin cancer incidence is increasing in fair-skinned populations," she says.

Data published this year shows that, in the UK, over 224,000 people were diagnosed with skin cancer in 2019, an increase of more than a quarter compared to 2013, when there fewer than 178,000 new diagnoses.

These numbers include both melanomas, which affect the pigment-containing cells involved in tanning, as well as other, more treatable types of cancer affecting other cells in the outer layer (epidermis) of the skin.

It’s worth noting that non-melanoma skin cancers, whilst less deadly, affect far more people and therefore still cause large numbers of deaths.

On a global scale, rates vary, but Eastern European countries are seeing some of the largest increases in melanoma. Meanwhile, there’s some evidence to suggest that in Australia, which has traditionally had the worst rates, skin cancer cases are starting to plateau, with recent declines seen in under 40s.

Globally, rates are expected to continue rising, with the International Agency for Research on Cancer predicting an increase from 1.5 million new skin cancer cases in 2020 to 2.7 million in 2040.

However, as Venables notes, it’s extremely difficult to predict the future. For example, we don’t yet know what impact climbing temperatures due to climate change will have.

It’s thought the rise we’re seeing now is related to changes in behaviour that started around the middle of the last century, Venables explains.

“Cheaper access to foreign travel from the 1980s and our ageing population are likely to be contributing to increasing skin cancer incidence,” she says.

Whilst the dangers of tanning may be well known, it seems not enough of us are following advice to stay out of the sun.

As Dr Gernot Walko, a skin cancer expert at Queen Mary University of London and University of Bath, explains, even the levelling-off of skin cancer rates in Australia may have less to do with people changing their behaviour than with the population itself changing.

“Australia, historically, had a European population, with lots and lots of people matching the high-risk criteria of having fair skin, red hair, freckles and so on,” he says. “Some scientists would argue that this is probably changing due to immigration.”

On the other hand, statistics on tanning beds do show that use has decreased, probably partly reflecting tighter restrictions on their use beginning in around 2009.

The proportion of adults using sunbeds dropped from 18 to 10 per cent between 2007-2012 and 2013-2018, whilst the proportion of adolescents using them dropped more dramatically, from 22 to 7 per cent.

However, as skin cancer is the result of a lifetime of UV exposure, we won’t know for a while how these decreases will affect diagnoses. Numerous studies have linked sunbed use to skin cancer, with those who use sunbeds more regularly, for longer periods, or at a younger age, facing a higher risk.

So what can we do to lessen our risk? Advice on sun tanning and sunbeds may be well publicised, but it bears repeating. As the NHS notes, “there is no safe or healthy way to get a tan” – all sun damage contributes to skin cancer risk.

Walko adds that by middle age, most of us will have accumulated some of the mutations known to cause skin cancer, but scientists aren’t sure what protects some people and not others from developing it.

We can look at public health messaging and conclude that we just need to cover up. But it’s not that straightforward – changing behaviour means changing attitudes.

It also means we need to stop idealising and glamorising tanned bodies. Take Love Island, says Walko: “If we see good-looking people tanning and running around in swimsuits, it doesn’t necessarily help with that societal image that we need to have a tan to look good.”

Meanwhile, dispelling some of the myths that keep people running back to the sunbeds couldn’t hurt. A 2022 study, for instance, drew attention to a couple of ill-conceived notions.

One, for example, is that artificial tanning can help with acne– but it’s actually red and blue light (containing no UV radiation) that are sometimes incorporated into acne treatments. Another is that sunbeds prepare the skin for sun exposure on holiday.

Governments could also do more. In 2010, the UK took the step of banning sunbeds for under 18s, but across the US and Europe, regulations and age restrictions differ. In some US states, it’s a matter of parental consent rather than an outright ban. Australia, by comparison, has outlawed sunbeds entirely.