Dr Thomas Stuttaford
We've made some changes
to The Sunday Times
An association between occupation, social class, dress, race and therefore skin colour, as well as family history, has been recognised for at least 100 years. The association between exposure of the skin to sun and melanoma, epitheliomas and basal cell carcinomas (rodent ulcers), the three common skin cancers, was noted originally because of the link between the jobs of the people suffering from them and the site of the cancers. At the time when both men and women kept as much of their skin as possible hidden from the sun's rays, and would always wear hats, all three of the more common skin cancers were found principally in those whose work kept them in the sun.
Once it became common for everyone to expose themselves to the sun, it was found that those who over-exposed themselves on holiday - to the extent that they became burnt by - were even more likely to develop cancer than the hardy old fisherman or farm worker who was weater-beaten rather than sunburnt.
Skin cancers have a long lead-in period. Research has shown that burning in childhood, when the skin is soft and pale, is more dangerous than becoming severely sunburnt in adult life. Holidays have altered the Victorian distribution of skin cancers. When once it was a disease of people labouring in the fields, now it is a problem for those who have played or laid on the beach from an early age. A sandy beach reflects the sun's rays, just as the sea does, so that the body is hit by ultraviolet rays from all angles.
Many of the richer, older patients who are now developing skin cancers are those whose parents were affluent enough 20, 30 or 40 years ago to take them for holidays overseas when they were children. For the past 15 or 20 years these holidays have been accessible to all but the poorest families. The popularity of holidays abroad is likely to result in an increase in the incidence of common skin cancers. Even though the overall numbers will soar it is probable that the existing class differences will be ironed out now that most people can afford to travel.
Once people from all backgrounds didn't keep themselves so well covered when they ventured into the sun it was found that those who over-exposed themselves to sun on holidays, to the extent that they became burnt by it, were even more likely to develop cancer than the hardy old fisherman or farm worker, who was weather-beaten rather than sunburnt.
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