Yes, more people are aware now, but as with any change of habits in society it takes time to see the results. The incidence of skin cancer in one of the places of the world with the greatest solar radiation, Australia, started to drop nearly three decades after the first awareness and prevention campaigns were carried out. On the Costa del Sol the first steps were taken ten years ago on a mammoth task: making people realise that the climate we so enjoyed posed a risk to our skin if we didn't use our heads. It was undertaken by the Costa del Sol hospital in Marbella and the district health authorities as part of a collaborative project which was a pioneer in Spain, trying to prevent skin cancer by raising awareness of the risks, encouraging people to protect themselves from the sun and improve early diagnosis.
The protection campaign used the slogan 'Enjoy the sun but don't forget about your skin'. It was no coincidence that it began on the Costa del Sol - there, the incidence of the most aggressive type of skin cancer, melanoma, was three times the average of the rest of the country and there were twice as many less serious cases than elsewhere.
“The number of skin cancer cases has not stopped increasing in recent years. Fifteen years ago our Dermatology department detected 30, now we have 130 patients with melanoma. The numbers keep growing, but that is partly because the campaigns are having an effect,” says Magdalena de Troya, the head of the hospital's Dermatology department and alma mater of the protection campaign. Her message today is the same as it was ten years ago: “We are not trying to scare or alarm anybody, we just want them to be aware of the importance of skin protection and of early diagnosis. Among other things, the campaign means that many cases are being detected earlier and we are talking about a hospital where, on average, we carry out about 700 operations on skin cancer a year,” she says.
The campaign is directed at different sections of the population: people who work outdoors, sunbathers, athletes, children and teenagers, people with a family history of melanoma. In total more than 4,000 people have taken part in campaigns on beaches, water parks, hotels, golf courses and schools, and these have identified around 300 possibly malignant lesions. The campaigns also help people to spot possible problems themselves and increases training for health professionals.
The figures for these ten years of effort are impressive: more than 1,200 professionals have been trained in diagnosing skin cancer and advising on prevention and 60 GPs have been trained in dermatoscopy, a technique which is now being used in 14 health centres on the Costa del Sol. In addition, 120 lifeguards, journalists, AECC volunteers and sports monitors have also been trained in sun protection and health advice.
“The campaign fits perfectly in the DNA of patient care at health centres. We are not only working to restore health in people with an illness; we are also informing them, training them, making them aware. In that sense the campaign is ideal,” says Nuria Delgado, a health education technician at the Costa del Sol health district. She says another strength of the campaign is that “we work on different levels. In other words, we attend to patients at health centres and the hospital and we are working together with a single aim, which is to prevent skin cancer on the Costa del Sol,” she explains.
Based on education
Those behind the campaign say support has been essential, such as that given by hotels, town halls and even Malaga university, which has carried out specific research. Some of the activities have been aimed directly at foreign tourists.
“We have raised awareness because we have worked in different sectors, but especially education,” says Magdalena de Troya. A special focus has been placed on this sector, with the creation of a distinction for schools which carry out sun protection campaigns and special training for teachers via the local teacher training centre, the CEP Marbella-Coín. More than 200 teachers and 2,000 pupils have taken part in an educational sun protection project and 20 schools in the area are already working on sun protection protocols in order to obtain the distinction. It is not enough for the schools to teach skin protection measures; they also have to take action on their own premises, such as creating shady areas in their playgrounds.
“When we started, I didn't even know what sun protection was,” says Antonio Rodríguez, a teacher who has been the director of the CEP for seven years. “We organised a course and so many people attended that we carried on.”
That was in 2011 and education regarding sun protection was, he says “something new in the classroom. We didn't realise how widespread the project would be, but altogether it has led to greater awareness,” he says.
The campaign has opened the way for similar actions in other parts of Spain, and on the Costa del Sol it will continue in a different form with the help of local councils who will carry out their own strategies to try to reduce the risk of overexposure to the sun, so they can proudly boast of having 'sun-safe beaches'.