The shocking survey of 1213 adults formed part of the Northern Ireland Omnibus Survey published in September 2008, a regular survey of the lifestyle and views of the people of Northern Ireland*.
It also found that people in their teens and early twenties are less likely than any other age group to use sun protection, despite increasing numbers of melanoma being diagnosed in this age group.
One in ten people surveyed (10%) take no protective measures at all against sun exposure (compared to 8% in 2000).
Men (14% vs. 7% women), unmarried people (13% vs. 8%), those with no children (11% vs. 9%) and those in their teens and early twenties (12%) are among the worst offenders.
Most people surveyed (70%) use sunscreen as their primary method of sun protection, despite warnings from dermatologists that shade and clothing should be the first line of defence against sun damage, with sunscreen offering additional protection.
Of respondents who use sunscreen, almost one in three (30%) use a low protection sunscreen of below SPF 15. This is an improvement from 57% in the same survey carried out in 2000 but is still concerning as the British Association of Dermatologists recommends that people use a high protection sunscreen of at least SPF 30.
Only a quarter of respondents (24%) protect their skin by seeking shade during the middle of the day, with a similar number (23%) covering up in the sun. Worryingly both methods are less popular in 2008 than they were in 2000.
Those most likely to protect their skin with clothing and shade fell into the 45 to 64 year and over-65 age groups. Women are more likely to use shade than men (29% vs. 18%), as are married people compared to unmarried people (26% vs. 19%), and those with children compared to those with no children (25% vs. 23%).
Sunscreen use is greatest among those aged 25 to 44 (77%), women (76% vs. 63%), married people (75% vs. 67%) and people with children (76% vs. 65%). Interestingly, although men are less likely to use sunscreen than women, those that do are more likely to use a SPF of 15 or over (73% vs. 68%).
Dr Rhonda Boyle, Dermatologist at Royal Victoria Hospital, Belfast, and one of the study's authors, said: "Unfortunately the results of this survey demonstrate that, despite public health campaigns, the use of sun protection and attitudes to sun safety in Northern Ireland remain concerning."
Nina Goad of the British Association of Dermatologists said: "Sunscreen seems to be the preferred way of protecting the skin, but it seems that many people may be forgetting to cover up and seek shade in the sun.
"It is worrying that people in their teens and early twenties are the least likely of any age group to protect their skin in the sun. This may be due to the prevailing fashion for tanned skin, but I would have hoped that young people would be more likely to use self tan products to get a bronzed look, rather than risking skin cancer. It may be that as people get older and start to see the visible sun damage on their skin, including wrinkles, they then take steps to protect themselves.
"It is really interesting that unmarried people and those without children take the least care in the sun - it would be worth examining what the obstacles are for these people, and perhaps we need to look at tailoring our prevention campaigns for specific audiences in the future."
The incidence of malignant melanoma in Northern Ireland (NI) has increased more than three fold since the 1970's with an almost parallel rise in melanoma-related deaths.
Summary of results
- Those aged below 25 are more likely than other age groups to use no sun protection at all (12% of this age group)
- Sunscreen use is highest in the 25 to 44 year age group (77%)
- Use of clothing and shade to protect skin is highest in those aged 45 and over.
- Women are more likely than men to use sunscreen (76% vs. 63%) and to protect the skin with shade (29% vs. 18%).
- Men are twice as likely as women to use no sun protection at all (14% vs. 7%)
- Although fewer men than women use sunscreen, those that do are more likely to use a SPF of 15 or over (73% vs. 68%).
Marital status and children
Married people are more likely than unmarried people to heed sun safety advice, as are people with children compared to those with no children:
- Those who are unmarried are more likely than married people to use no sun protection (clothing, shade or sunscreen) at all (13% vs. 8%)
- People with no children are more likely to not use any sun protection (clothing, shade or sunscreen) than those with children (11% vs. 9%)
- Married people are more likely to use sunscreen than unmarried people (75% vs. 67%), as are subjects with children compared to those with no children (76% vs. 65%).
Choice of sun protection
- 70% use sunscreen as their primary method of sun protection.
- Of those who use sunscreen only 70% use a SPF of 15 or over.
- Only a quarter of respondents (24%) protect their skin by seeking shade during the middle of the day, with a similar number (23%) covering up in the sun.
- Notably one in ten people (10%) take no protective measures at all against sun exposure
Facts about skin cancer
- There are three main types of skin cancer: malignant melanoma - the deadliest but least common, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC).
- BCC and SCC are collectively known as 'non-melanoma skin cancer'. BCC is the most common skin cancer.
- In the UK, more than 100,000 new cases of skin cancer are diagnosed annually, making it the most common cancer. Of these, more than 10,000 are melanoma.
- There are over 2,300 deaths from skin cancer annually in the UK.
- The annual incidence of melanoma worldwide is increasing faster than that of any other cancer.
- In just 30 years, cases of melanoma across Great Britain have quadrupled in men and tripled in women.
- Melanoma is more common in women than men, but there is a faster rate of increase in men and more men die from the disease, possibly due to late detection.
- In as many as 4 out of 5 cases, skin cancer is preventable, so follow the British Association of Dermatologists' sun safety tips:
You don't have to avoid the sun all year, and some sunshine can be good for you as it helps the body to produce vitamin D, but taking a few steps when out and about in the summer sun or when on a sunshine holiday will help to protect you from sunburn and the risk of skin cancer, particularly if you are pale skinned.
- Protect the skin with clothing, including a hat, T shirt and UV protective sunglasses
- Spend time in the shade between 11am and 3pm when it's sunny
- Use a sunscreen of at least SPF 30 (SPF 50 for children or people with pale skin) which also has high UVA protection
- Keep babies and young children out of direct sunlight
- The British Association of Dermatologists recommends that you tell your doctor about any changes to a mole - if your GP is concerned about your skin, make sure you see a Consultant Dermatologist (on the GMC register of specialists), the most expert person to diagnose a skin cancer. Your GP can refer you via the NHS.
Sunscreens should not be used as an alternative to clothing and shade, rather they offer additional protection. No sunscreen will provide 100% protection.
If using this study, please ensure you mention that the study was released at the British Association of Dermatologists' Annual Conference.
The conference will be held at the Scottish Exhibition & Conference Centre, Glasgow from July 7th to 10th 2009, and is attended by UK and worldwide dermatologists and dermatology nurses.
*The NI Omnibus Survey is carried out by the Northern Ireland Central Survey Unit and from 2000 has included 'care in the sun' questions, as proposed by the Northern Ireland Melanoma Strategy Implementation Group (NIMSIG).
Sun protection practices in Northern Ireland: results from the NI Omnibus Survey September 2008 R Boyle1, AH O'Hagan2, S Gordon3, G McIlwee3, P Loan4, A Gavin5, C Mason6 1Department of Dermatology, Royal Victoria Hospital, Belfast, Northern Ireland, United Kingdom, 2Department of Dermatology, Craigavon Area Hospital, Craigavon, Northern Ireland, United Kingdom, 3Ulster Cancer Foundation, Northern Ireland, United Kingdom, 4Department of Medical Physics, Northern Ireland, United Kingdom, 5Northern Ireland Cancer Registry, Northern Ireland, United Kingdom, 6Public Health Department, Western Health and Social Services Board, Northern Ireland, United Kingdom
The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.
British Association of Dermatologists