Soldiers deployed to sunny climates are not being adequately protected from the most common cancer type, according to a study presented at the World Congress on Cancers of the Skin in Edinburgh, Scotland.
Skin cancer refers to a group of cancers predominantly caused by unprotected exposure to the sun, of which melanoma is the most dangerous. Melanoma claims 2,200 lives in the UK and 9,700 in the US each year.
Previous research has shown that 34 per cent of US military veterans who developed melanoma had also been deployed to tropical climates. In comparison, only six per cent of non-military melanoma patients had spent time in tropical climates.
This latest study, conducted by researchers from Vanderbilt University School of Medicine in the US, found that only 22 per cent of military personnel were made very aware of the risks of sun exposure. Furthermore, whilst 77 per cent reported being exposed to bright sunlight for more than four hours a day, only 27 per cent had regular access to sunscreen. Just under a third of respondents (32 per cent) reported having no access to sunscreen at all.
Consequently, a staggering 62 per cent of military personnel reported getting sunburnt while deployed abroad, including cases of skin blistering. 29 per cent have noted a change in the colour, shape or size of their moles (often a sign of skin cancer) since being deployed to tropical zones, however only four per cent had received a skin examination from a physician since deployment.
Johnathon Major, of the British Association of Dermatologists commented: “While this study relates specifically to the US, additional research* highlights a correlation between UV induced skin tumours and UK service personnel. Skin cancer may not seem like a priority when you consider the other dangers faced by soldiers, but the disease is preventable and poses a significant risk. We need to consider how best to ensure that anyone who works outdoors, including soldiers, knows the risks and has access to sun protection.”
Jennifer Powers, Assistant Professor at Vanderbilt University and Head Researcher of this study added: “The past decade of United States’ combat missions, including operations in Iraq and Afghanistan, have occurred at a more equatorial latitude than the mean centre of the United States population, increasing the potential for ultraviolet irradiance and the development of skin cancer. This study demonstrates room for improvement for skin cancer prevention and early detection in the military population, including possible screening of higher risk personnel.”
Notes to editors:
More information on melanoma and skin cancers can be found at http://www.bad.org.uk/for-the-public/skin-cancer
*Burden of Occupational Cancer in Great Britain: http://www.hse.gov.uk/research/rrpdf/rr860.pdf
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The conference will be held in Edinburgh from September 3rd to 6th 2014, and is attended by approximately 1,000 UK and worldwide health professionals.
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Incidence of skin cancer risk factors experienced by United States military personnel during recent overseas deployments.
Jennifer Powers1, Neelam Patel4, Edward Powers4, George Stricklin2, Alan Geller3
1Vanderbilt University School of Medicine, Division of Dermatology, Nashville, TN, USA, 2Tennessee Valley Healthcare System, Nashville, TN, USA, 3Harvard School of Public Health, Boston, MA, USA, 4Vanderbilt University School of Medicine, Nashville, TN, USA
Background: A retrospective study of Veterans showed that those with melanoma had high rates of deployment in tropical climates (34%) versus age-matched controls (6%) (p=0.0002) . A retrospective review of tumor registries showed melanoma incidence to be higher in military personnel aged 45 or older (p< 0.05) . The past decade of United States’ combat missions, Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF)/Operation New Dawn (OND), have occurred at a more equatorial latitude (33°N) than the mean center of the United States Population (38°N)  increasing the potential for ultraviolet irradiance and the development of skin cancer.
Hypothesis: United States military workers engaged in recent OEF/OIF/OND deployments have skin cancer risk factors.
Methods: A 30-question survey was offered to recent OEF/OIF/OND Veterans presenting to the Nashville Post-Deployment Clinic at the Tennessee Valley Healthcare System (TVHS). Data from 197 surveys was analyzed using Microsoft Excel® and GraphPad® statistical software.
Results: 64% identify as Caucasian, 22% as African-American, 8% as Hispanic. 48% were fair-skinned. 50% as non-fair skinned. 22% report being made very aware of the risks of skin cancer versus 42% who report none at all. 77% had 4 or more hours of bright sun exposure during a typical day and 52% reported 7 or more hours. Only 27% noted ready access to sunscreen while working versus 32% with no access and 40% with limited access. 62% of respondents had at least one sunburn during deployment, with 42% noting two or more sunburns and 16% reporting four or more sunburns; 15% had at least one blistering sunburn.
29% of veterans observed changes in size, shape or color of moles since deployment, however, only 4% had a skin exam performed by a physician since deployment.
This study demonstrates room for improvement for skin cancer prevention in the Veterans population.
1. Brown J, Kopf AW, Rigel DS, Friedman RJ. Malignant melanoma in World War II veterans. Int J Dermatol. Dec 1984;23(10):661-663.
2. Zhou J, Enewold L, Zahm SH, et al. Melanoma incidence rates among whites in the U.S. Military. Cancer Epidemiol Biomarkers Prev. Feb 2011;20(2):318-323.
About the BAD
The British Association of Dermatologists (BAD) is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease. The BAD provides free patient information on skin diseases and runs a number of high profile campaigns, including Sun Awareness, which runs from May to September annually and includes national Sun Awareness Week in May. Website: www.bad.org.uk/sunawareness
Published on September 2, 2014