Sunbed use 2007–2015 and skin cancer projections of campaign results 2007–2040 in the Danish population: repeated cross-sectional surveys

OBJECTIVE: To evaluate the effect of the Danish Sun Safety Campaign 2007–2015 on the prevalence of sunbed use and to model future effects on the skin cancer incidences 2007–2040. DESIGN: The study has a repeated, cross-sectional design. SETTING: Exposure to ultraviolet radiation is the main risk factor for skin cancer. Denmark has the highest prevalence of sunbed use reported and one of the highest incidences of skin cancer worldwide. PARTICIPANTS: During 2007–2015, survey data were collected for 37 766 Danes, representative of the Danish population with regards to age, gender and region. INTERVENTIONS: In 2007, an ongoing long-term antisunbed campaign was launched in Denmark. PRIMARY AND SECONDARY OUTCOME MEASURES: Sunbed use was evaluated by annual cross-sectional surveys. Skin cancer incidence was modelled in the Prevent programme, using population projections, historic cancer incidence, sunbed use exposure and relative risk of sunbed use on melanoma. RESULTS: The prevalence of recent sunbed use in Denmark was reduced from 32% and 18% to 13% and 8% for women and men, respectively. The campaigns results during 2007–2015 are estimated to reduce the number of skin cancer cases from more than 5000 (746malignant melanoma, 1562 SCC, 2673 BCC) totally during 2007–2040. Keeping the 2015 level of sunbed use constant by continued campaign pressure or introduction of structural interventions would potentially prevent more than 750 skin cancer cases annually in 2040 and 16 000 skin cancer cases in total during 2007–2040. CONCLUSION: We have shown the value of prevention and of long-term planning in prevention campaigning. Sunbed use was reduced significantly during 2007–2015 and further reductions are possible by structural interventions. Consequently, significantly fewer skin cancer cases are anticipated during 2007–2040. The Danish Parliament has population support to enforce structural interventions to avoid a large burden of this disease.