Skin Cancer Prevention Plan 2019-2022

Objectives

The Skin Cancer Prevention Plan 2019-2022 seeks to reverse Ireland’s rising skin cancer incidence by increasing awareness and uptake of evidence-based prevention behaviours.[1]It applies a primary-prevention focus that reduces harmful ultraviolet exposure, promotes protective practices and discourages sunbed use, while recognising national recommendations on early detection and survivorship.[2][3]

• Increase public awareness of skin cancer risk and improve adoption of protective behaviours through education, media activity, environmental measures and policy change across multiple settings.[1]
• Prioritise children and young people, outdoor workers, outdoor leisure participants, and people using sunbeds or exposed to other artificial ultraviolet sources.[2][1][4][5][6]
• Protect children during early life because ultraviolet exposure in the first 10 to 15 years contributes disproportionately to lifetime skin cancer risk.[3]
• Promote checking the ultraviolet index, with protection recommended when the international UV Index is 3 or above.[3][1]
• Encourage covering skin, using broad-spectrum sunscreen, wearing a wide-brimmed hat and ultraviolet-protective sunglasses, seeking shade, avoiding deliberate tanning and sunburn, and never using a sunbed.[1]
• Discourage sunbed use because ultraviolet-emitting tanning devices are classified as carcinogenic to humans by the International Agency for Research on Cancer.[3]
• Deliver action through seven areas: oversight; national awareness and behaviour change; children and young people; outdoor workers; outdoor leisure; sunbeds and other artificial ultraviolet sources; and monitoring, research and evaluation.[7]
• Develop practical education, communication and prevention resources for early learning and care, schools, workplaces, sport, tourism, recreation and community settings.[4][5][6]
• Establish baseline measures of national awareness and prevention behaviours, monitor change, and evaluate effectiveness to guide interventions and future plans.[1][7][6][8]

Implementation

The plan uses Healthy Ireland’s whole-of-government and whole-of-system approach, bringing together public bodies, health services, professionals, non-governmental organisations, private-sector organisations, patients and the public to deliver consistent skin cancer prevention action.[2][1]Implementation is intended to combine public education, protective policies and practices, targeted support for priority groups, professional engagement, cross-sectoral collaboration and mass-media communications.[9]

• Govern implementation through structures aligned with the National Cancer Strategy, including a plan coordinator, a cross-sectoral advisory group, stakeholder relationships, reporting arrangements and annual implementation review.[7]
• Lead governance actions through the Department of Health and the National Cancer Control Programme, with an implementation group supporting advisory arrangements, stakeholder engagement and reviews.[7]
• Coordinate delivery with the Health Service Executive and partners across education, child and family services, regulation, occupational safety, sport, tourism, local government and community organisations.[4][5][6]
• Agree standardised, evidence-based national prevention messages; develop resources and annual communications plans; and integrate prevention content into existing education, training and communication channels.[7][4]
• Support legislation, policy and implementation of protective behaviours, including monitoring public-health sunbed legislation and its enforcement through the Health Service Executive Environmental Health Service.[7][6]
• Deliver targeted prevention through early learning settings and school curricula, parent communications, workplace policies, outdoor leisure organisations and sunbed-risk communications.[5][6]
• Include children and young people in developing resources and programmes, prioritise shade in early-learning design guidance, and engage employers, employee groups, the Health and Safety Authority, sports bodies and managers of outdoor recreation areas.[5][6]
• Use National Cancer Registry Ireland data to inform implementation, develop a profile of schoolchildren’s ultraviolet exposure risk and protective behaviours, and identify research needs as implementation progresses.[7][5][6]
• Develop a monitoring framework using baseline data and agreed outcome measures, collate research on changes in awareness and behaviours, produce annual progress updates, and conduct a formal implementation review in 2022 to inform future direction.[6][8]
• Use the Irish Cancer Prevention Network to align prevention work with the National Cancer Strategy 2017-2026, coordinate initiatives, support programmes, disseminate research, agree public messages and facilitate peer learning.[8]
• Explore evidence-based fiscal measures that could support prevention behaviours during 2019-2022; the plan does not specify budgets, funding sources, allocations or costings.[4][1][7]

Monitoring & Evaluation

The plan establishes monitoring, research and evaluation as a core action area, using baseline data, outcome measures, implementation learning and annual review to assess progress in skin cancer prevention and inform future plans.[7][6][8]

• Establish baseline measures of national awareness and engagement in skin cancer preventive behaviours to guide interventions and identify key outcome measures.[7][4][6][8]
• Develop a monitoring framework in 2019, led by the National Cancer Control Programme and Department of Health with the Implementation Group and relevant partners.[8]
• Collate and undertake research on changes in awareness and preventive behaviours, initially scheduled for 2019, and identify and pursue further research needs throughout implementation.[7][6][8]
• Use data from the National Cancer Registry Ireland to inform and guide implementation.[7][4][6]
• Develop a profile of schoolchildren's ultraviolet exposure risk and protective behaviours to strengthen evidence for interventions affecting children and young people.[5][6]
• Produce annual progress updates and conduct an implementation review in 2022 to determine future direction.[7][8]
• Align oversight and reporting arrangements with the National Cancer Strategy 2017-2026.[7][8]

Accountability for annual implementation review is assigned to the National Cancer Control Programme working with the Implementation Group.[7]Monitoring and review of public health sunbed legislation and its enforcement are assigned to the Health Service Executive Environmental Health Service.[6]The plan also calls for examination of the feasibility of eliminating sunbed use and identification of emerging artificial ultraviolet sources.[6]

The Irish Cancer Prevention Network is intended to support coordinated implementation by aligning prevention activity with the National Cancer Strategy, supporting national programmes, coordinating initiatives, agreeing consistent evidence-based public messages, disseminating research and facilitating peer learning.[8]It was established by the National Cancer Control Programme, Marie Keating Foundation, Irish Cancer Society and Breakthrough Cancer Research.[8]

The document draws on national skin cancer incidence and behaviour data in plan development and identifies research and evaluation as necessary to maintain consistent, continuous prevention programmes.[10][9]International evidence cited includes reported reductions in skin-cancer rates among young people in Victoria and levelling melanoma rates among people under 35 in New Zealand.[9]

Although the plan provides for baseline measurement, outcome measures, research, annual updates and review, it does not specify a detailed quantitative indicator set, indicator baselines or targets, reporting templates, evaluation methodology, surveillance targets, or consequences for non-performance.[7][6][8]

Costing & Financing

No dedicated budget, programme costing, funding allocation, financing source, resource mobilisation mechanism, funding gap or economic assumption is specified for implementation of the Skin Cancer Prevention Plan, including its monitoring, research and evaluation actions.[1][7][4][5][6][8]

• Recognise prevention as the most cost-effective long-term approach to cancer control.[2]
• Explore the feasibility of evidence-based fiscal measures that support skin cancer prevention behaviours during 2019 to 2022.[4]
• Note international economic evidence reporting that Victoria's SunSmart programme generated a return of 2.20 for every dollar spent; the source does not provide the currency, costing method or applicable period.[9]

The available material does not indicate whether delivery actions, communications, education resources, shade measures, workplace interventions, sunbed enforcement, research or governance arrangements received new or existing funding.[1][7][4][5][6]