Background: The Australian Skin and Skin Cancer Research Position Statement on the risks and benefits of sun exposure divides people into skin-type groups; low-, moderate- and high-risk of skin cancer. We compared the expected health and cost outcomes of the status quo with the scenario where populations adhered to the Position Statement advice. The priority was preventing skin cancer while acknowledging the importance of vitamin D for bone health and the immune system.
Methods: The SUNEX model simulated five diseases that are associated with over- or under-UVR exposure (i.e., melanoma, keratinocyte skin cancer (KC), cataract, multiple sclerosis, fragility fractures). The main behaviour changes were avoiding the sun when the UV index > 3 for high-risk people and increasing sun exposure for vitamin D sufficiency for low-risk people. We assessed the relative case numbers, deaths and health system costs for each disease over 20 years for Australia and New Zealand.
Results: Using Queensland as an example, the advice resulted in decreased sun exposure by 14 hours per month among high-risk people and increased by 19 hours among low-risk people. Adhering to the advice led to reduced cases of melanoma (35%) and KC (33%) and increased cases of fragility fractures (15%) and multiple sclerosis (24%). Across 20 years, there was $6.5 billion increase in healthcare costs and 20,500 additional deaths (predominantly due to fragility fractures).
Conclusion: The consequences of following the advice to differing degrees by skin type and latitude will be presented, highlighting there are trade-offs when multiple diseases are considered.