National Skin Cancer Prevention Plan 2023-2026

Objectives

The National Skin Cancer Prevention Plan 2023-2026 provides Ireland’s national framework for population-wide prevention, supporting the National Cancer Strategy 2017-2026 and seeking to reverse the rising incidence of skin cancer by increasing awareness and adoption of protective behaviours throughout life.[1][2][3]Its primary focus is prevention of ultraviolet-related skin cancer rather than vitamin D or early-diagnosis activity.[4]

• Increase awareness of skin cancer prevention and improve adoption of protective behaviours, while monitoring change and evaluating effectiveness.[3]
• Promote the SunSmart code, including reducing time in intense sunlight, seeking shade, covering skin, wearing a wide-brimmed hat and ultraviolet-protective sunglasses, using sunscreen correctly, avoiding deliberate tanning and sunburn, and never using sunbeds.[4][5]
• Encourage protection when the ultraviolet index is 3 or above, particularly during Ireland’s higher-exposure period from April to September.[6][5]
• Address ultraviolet radiation from sunlight, sunbeds and other artificial sources, which are central preventable risk factors for skin cancer.[7][8]
• Prioritise prevention awareness and behaviours; children aged 0-12; adolescents and young adults aged 13-24; outdoor workers; sport, recreation and tourism; sunbeds and other artificial ultraviolet sources; and oversight, monitoring, research and evaluation.[9][3]
• Use education, public-awareness and behaviour-change campaigns, environmental measures and policy changes across early learning, school, workplace, recreation and community settings.[3]
• Protect groups facing heightened exposure or vulnerability, including children, outdoor workers, people who use sunbeds, people with fair skin, and people who are immunosuppressed.[10][7][3]
• Challenge tanning culture and risk-taking associated with deliberate tanning, particularly among younger women.[4]
• Reduce demand for sunbeds through awareness, information, research, regulatory review and exploration of evidence-based fiscal measures by 2026.[8]

Implementation

The plan adopts a coordinated, multi-sectoral Healthy Ireland approach, led through the National Cancer Control Programme, Healthy Ireland and Met Éireann, with an Implementation Group and partners across government, health, education, employment, community, sport, recreation and private-sector settings.[1][3][11]Delivery builds on the established SunSmart campaign and combines national communications with setting-specific resources, training, environmental protection and policy activity.[12][11]

• Deliver annual SunSmart communications plans from 2023 to 2026, using evidence-based messaging, stakeholder support and social media engagement.[11]Social-media engagement exceeded 120,000 in 2020 and 300,000 in 2022.[13]
• Provide location-specific ultraviolet index readings and associated protection messaging through Met Éireann.[11]
• Engage parents, early learning and childcare settings, schools, colleges and universities to develop and disseminate age-appropriate skin-protection education and resources.[14]Use Social, Personal and Health Education and primary Science curricula as school-based intervention routes.[11]
• Develop targeted communications and interventions for adolescents and young adults, informed by previous research involving people aged 12-18.[14]
• Strengthen occupational protection for outdoor workers through workplace policies, environmental controls, personal protective equipment, employer resources, training and healthy-workplace initiatives.[15]
• Work with sports organisations, recreation-area managers, tourism partners and local authorities to promote role modelling, shade and other protective measures in outdoor settings.[15]
• Use education, communications, community outreach and enforcement review to address sunbed use, tailoring initiatives towards groups with the highest use.[8]
• Integrate prevention education into health and social care professional training and link primary prevention activity with relevant early-diagnosis work.[11]
• Re-establish the Implementation Group with key stakeholders, led by the National Cancer Control Programme and Healthy Ireland, and report implementation through the National Cancer Strategy from 2023 to 2026.[16]The group includes expertise from health service programmes, the Department of Health, hospitals, general practice, cancer charities, research organisations and public representatives.[17]
• Submit an annual Implementation Group progress report to the Department of Health covering action areas and new developments.[13]Undertake a formal review at the end of each calendar year against objectives, targets and action areas, using findings to inform future plans.[13][3]
• Monitor short- and medium-term changes in awareness, knowledge and behaviour, including reported sun protection, sunburn, sunbed use and time spent in the sun, recognising that changes in skin cancer rates will not be measurable in the short term.[5][13]
• Assess the annual SunSmart campaign against best practice and evaluate targeted initiatives as appropriate.[16]Conduct research on prevention awareness and behaviours, sunbed use and tanning motivations, and the use and effectiveness of shade.[8][16]

Monitoring & Evaluation

Monitoring, research and evaluation are a dedicated action area, intended to track changes in skin-cancer prevention awareness and behaviours, assess implementation, and use learning to improve future plans.[9][3][16]The plan recognises that changes in skin cancer incidence will not be measurable in the short term, so monitoring focuses on nearer-term awareness, knowledge and behaviour outcomes.[13]

• Monitor population and school-age measures including reported sun-protection practices, sunburn, sunbed use and time spent in the sun.[5][13]
• Use identified, collated and commissioned research during 2023-2026 to monitor prevention awareness and behaviours, including research on sunbed use, user characteristics, tanning motivations, shade use and the effectiveness of shade.[8][16]
• Assess the annual SunSmart communications campaign against best practice, including awareness, knowledge and behaviour change; social-media engagement exceeded 120,000 in 2020 and 300,000 in 2022.[13][16]
• Produce annual evaluation reports and undertake formal end-of-calendar-year reviews against the plan’s objectives, targets and action areas, using findings to refine interventions, messaging and future plans.[13][3]
• Provide an annual Implementation Group progress report to the Department of Health on action areas and new developments, while reporting implementation through the National Cancer Strategy 2017-2026 between 2023 and 2026.[13][3][16]
• Monitor and review enforcement of public-health sunbed legislation through the Health Service Executive Environmental Health Service, review the health information required for sunbed users, and consider research on emerging artificial ultraviolet sources.[8]

Evidence informing the plan includes literature review, cancer-registry incidence trends and projections, epidemiological data, surveys and international intervention research.[18][19][20][21]However, the supplied material does not provide a comprehensive quantified indicator framework, indicator baselines or targets, a detailed surveillance protocol, or a fully specified evaluation methodology.[9][18][19]

Costing & Financing

No budget, programme-level financial plan, resource allocation, quantified funding gap or economic assumptions are specified for the National Skin Cancer Prevention Plan 2023-2026.[9][5][13][14][15][8]

• Use prior Sláintecare Integration Fund support as an implementation resource: it funded a Cancer Prevention Co-ordinator for the 2019-2022 plan, but the amount and any continuation of this support are not specified.[1]
• Recognise prevention and early diagnosis as economically important because cancer prevention is characterised as a cost-effective long-term approach, and research has examined the economic cost of skin cancer in Ireland.[12][2]
• Address the substantial cost differential between melanoma stages: management of stage IV melanoma cost Euro 122,985, compared with Euro 4,269 for stage IA melanoma.[10]
• Consider the financial pressure associated with rising melanoma incidence and health-price inflation, which reinforces the case for prevention and earlier diagnosis.[10]
• Explore the feasibility of evidence-based fiscal measures relating to sunbeds in 2026; the proposed measure, expected revenue, implementation cost and economic assumptions are not specified.[8]