THE SUNDAY TELEGRAPH – 18 Jul 1999
Sunbathing, ‘skin cancer’ and sore confusion
FOR MILLIONS of people, sunbathing is an innocent pleasure – a special sort of sensuous, if mindless, form of relaxation. It is also, to be blunt, about sex; for it is not possible to sit on a beach, or even in a central London park, surrounded by scantily clad and gilded strangers, without thinking about such matters. All the more reason then for it to be the target of the bossy-boots brigade who, for the past five years, have been disturbing the peace of mind of the nation’s sun lovers with dire warnings about the risk of skin cancer.
It would be only natural to presume they must at least have a watertight case, but, as an article in the British Medical Journal last week points out, they do not. On the contrary, the prohibition against sunbathing turns out to be based on a tenuous association with malignant skin cancers, while denying people its several benefits – which include promoting mental wellbeing and protection against rickets and skin disorders such as eczema and psoriasis. "Sunbathing is healthy", our sister paper, The Daily Telegraph, announced gleefully on its front page, next to the disgruntled experts complaining that the authors of the BMJ article "threatened to undo many years of good [sic] health education".
None of this will come as much of a surprise to regular readers,; as I have in the past drawn attention to the intellectual deception that sustains the health propaganda about the so-called dangers of sunbathing.
The ultraviolet rays of the sun certainly can predispose to "skin cancer". I use inverted commas because it is not a cancer in the commonly accepted sense of the word; rather, it is a highly localised patch of abnormal skin, more commonly known as "a rodent ulcer", which may occur on exposed areas, such as the head, hands and face, particularly in farmers, fisherman and others pursuing an outdoor occupation.
It does not spread to other parts of the body, is not life-threatening and is easily cured by a short course of X-ray treatment or surgery.
By contrast, the characteristics of the much more sinister malignant skin cancers, or melanomas, could not be more different. They tend to occur on non-exposed parts of the body, such as the trunk and backs of the legs, most frequently in those who work indoors. Clearly, prolonged sun exposure cannot be responsible.
The trick, of course, is to lump all these skin cancers together and infer from the undoubted role of ultraviolet light in rodent ulcers that the same applies to melanomas. Hence the anxiety-mongering allegation that sunbathing costs "2,000 lives a year".
There are further inconsistencies. Melanoma is common in Australia, implying a link with sun exposure, but in the northern hemisphere the situation is reversed, and in Britain the incidence is much higher among those brought up in the rain-swept highlands than the sunny south. Perhaps the recent vogue for Mediterranean holidays might be important? But those unfortunate enough to develop melanoma spend no more or less time abroad than anyone else.
When I first raised these matters in my column, they elicited three memorable responses. The first came from an international organisation of naturists. They wrote to say that my observations would be of considerable reassurance to tens of thousands of worried nudists around the world. Next a retired soldier commented that during the time he and his comrades had been chasing Rommel around the north African desert, they had worn little more than shorts and a sun hat. But no one, to his knowledge, had ever died of skin cancer as a result.
The third letter, from a skin specialist, was rather different in tone, accusing me of "gross irresponsibility". Prolonged sun exposure may not be the cause of malignant melanoma, he conceded, but did I not know that there was a statistical association with episodes of sunburn in childhood? This is true, but as the fair-skinned are much more vulnerable to sunburn than the dark-skinned and 70 times more likely to develop melanoma, it is not possible to determine whether sunburn makes any contribution at all.
The problem, as so often, is that "the experts" feel impelled to provide explanations even when they do not really understand what is happening. The incidence of malignant melanoma appears to be rising. Why? The connection with sun exposure is easily made, and even though the evidence is highly inconsistent, it is asserted as proven fact. Then when, as happened last week, somebody else takes a dispassionate look at the facts and finds them less than compelling, the result is confusion and red faces all round.
Copyright: Telegraph Group Ltd