The Australian experience in sun protection and screening for melanoma.

Australia has the world's highest incidence of skin cancer. Despite excellent prevention and early diagnosis education programs and an increasing percentage of the population with darker and more UV tolerant skins, skin cancer remains a major and expensive community medical problem. However, primary and secondary prevention programs are now showing positive outcomes, especially in melanoma incidence and survival. Primary and secondary prevention programs are conducted by a variety of non-government organizations such as the Australian Cancer Council, which is comprised of state anticancer groups, with some assistance from State and Federal health agencies. Current and future campaigns are becoming focused on specific community groups, noticeably teenagers and the older population. The role of sunscreens as the primary preventative approach has been superceded by sunlight avoidance campaigns. In light of an increasing rate of early diagnosis, a low and falling morbidity of melanoma, improving general practitioner competence in skin cancer diagnosis and proliferation of skin cancer clinics throughout Australia, it is unlikely a national skin cancer screening program will be implemented. Ozone depletion, a sunlight overloaded environment, increased leisure time and an outdoor lifestyle necessitate continued efforts to minimise the cost and morbidity of skin cancer in Australia.