Awareness of cancer among adolescents: A study of nine focus groups in Aotearoa New Zealand.

ISSUE ADDRESSED: One third of cancers are potentially preventable by modifying key risk factors that arise during adolescence. To help inform prevention efforts, we investigated adolescents' understanding of cancer risk factors, symptoms and signs and barriers to help-seeking. METHODS: Nine focus groups were conducted with purposefully sampled, binary-gendered friendship groups of 12 to 17-year-olds. Interviews were analysed using a qualitative descriptive method based on the topic schedule, transcripts and field notes. RESULTS: Behavioural, genetic and environmental factors were commonly explored as risk factors. Most cancer symptoms identified focused on physical indicators, such as lumps and skin appearance. Facilitators and barriers to good health choices involved both external and internal factors: education, affordability, attitudes and the social environment. Most participants indicated they would talk to trusted friends and family members about health issues, but only when the condition became 'serious'. The most common source of health information was the internet. CONCLUSIONS: Adolescents have a good understanding of behavioural risk factors, but poor knowledge of some key cancer symptoms. A support system was recognised to be a substantive factor in dealing with health issues, as were youth-focused health services. Understanding of the preventability of many cancers was not widespread with participants. SO WHAT?: The results emphasise a requirement for appropriate, affordable and accessible youth-focused health services. There is a need for age- and culturally appropriate interventions that improve knowledge of cancer symptoms. Immunisation against the viruses implicated in cervical cancer is one example of a clinical cancer prevention intervention in adolescence.

Societal burden of work on injury deaths in New Zealand, 2005-14: An observational study.

Background: Work poses increased risk of injury not only for workers but also for the public, yet the broader impact of work-related injury is not quantified. This study, utilising population data from New Zealand, estimates the societal burden of work-related fatal injury (WRFI) by including bystanders and commuters. Methods: This observational study selected deaths due to unintentional injury, in persons aged 0-84 years using International Classification of Disease external cause codes, matched to coronial records, and reviewed for work-relatedness. Work-relatedness was determined by the decedent's circumstances at the time of the incident: working for pay, profit, in kind, or an unpaid capacity (worker); commuting to or from work (commuter); or a bystander to another's work activity (bystander). To estimate the burden of WRFI, frequencies, percentages, rates, and years-of-life lost (YLL) were estimated. Results: In total 7,707 coronial records were reviewed of which 1,884 were identified as work-related, contributing to 24% of the deaths and 23% of the YLL due to injury. Of these deaths close to half (49%) occurred amongst non-working bystanders and commuters. The overall burden of WRFI was widespread across age, sex, ethnic and deprivation sub-groups. Injury deaths due to machinery (97%) and due to being struck by another object (69%) were predominantly work-related. Interpretation: When utilising a more inclusive definition of work-relatedness the contribution of work to the societal burden of fatal injuries is substantial, conservatively estimated at one quarter of all injury deaths in New Zealand. Other estimates of WRFI likely exclude a similar number of fatalities occurring among commuters and bystanders. The findings, also relevant to other OECD nations, can guide where public health efforts can be used, alongside organisational actions, to reduce WRFI for all those impacted.

National Sporting Organisation policies: A health promotion opportunity?

ISSUE ADDRESSED: The objective was to identify whether National Sporting Organisations (NSOs) have policy documentation on healthy behaviours (smokefree, sun-protection, healthy food/beverages and alcohol) and, for organisations with such documentation, whether this was in-line with current scientific evidence of past best practice in cancer prevention. METHODS: This cross-sectional policy analysis study was performed September to December 2018 in Aotearoa/New Zealand. A content analysis was undertaken using NSO policy documents matched against a framework of key indicators for best practice within health behaviours of interest. Data analysis of the policy process was undertaken through key informant telephone interviews with NSO staff using semi-structured qualitative interviews. RESULTS: Of 96 NSOs, nearly half (49%) mentioned smokefree at least once in one of their policy documents, and 47% had an alcohol policy, although in both instances the policies lacked comprehensiveness. Two NSOs had a reasonably comprehensive sun protection policy. Seventeen had at least one specific nutrition policy/guideline. The contents of the latter were primarily related to short-term athletic performance rather than non-communicable disease prevention, specifically promoting hydration during sports participation, and food and nutrition to support sporting performance. Two NSOs had policies relating to the promotion of healthy food/nutrition more widely. For some NSOs, the lack of health-related policies was not a conscious choice but just not considered previously. Other NSOs reported they lacked resources or had other priorities. CONCLUSIONS: Although this study clearly demonstrates that many NSOs lack adequate health-related policies, this is not necessarily a conscious choice, but the result of a lack of resources, other priorities, or just that they had not considered developing policies in these areas. A number expressed support for these types of policies although it was apparent that some, particularly smaller NSOs, would require assistance in policy template development. It seems probable that the development of health-related policies will only occur if partner agencies become involved.

A novel skin cancer prevention strategy: Preservice teachers' perceptions of a sun safety intervention and experiences in schools.

ISSUE ADDRESSED: Teachers play a vital role in developing children's sun protection routines however upskilling preservice teachers (PSTs) while at university has not yet been trialled as a targeted skin cancer prevention strategy. Hence, this study investigated PSTs perceptions and experiences of sun safety following a brief pilot intervention and placement in primary schools in Western Australia. METHODS: This study used a triangulation mixed methods design. Participants (n = 161) completed a post intervention survey which was analysed quantitatively. A random sub-sample was invited to participate in focus groups (three groups, n = 21) and one-on-one interviews (n = 4). This data was transcribed and uploaded in NVIVO software for thematic analysis. RESULTS: Participants felt the intervention increased their awareness of the dangers of overexposure to ultraviolet radiation (UVR) with many feeling more knowledgeable, skilled and confident to teach sun safety in school settings. Most reported clear sun safety messages in their placement schools. However, only 34.4% reported they had been briefed on the school's sun safety procedures. There was consensus among PSTs that sun protection in primary schools needs to be improved to maximise the protection of children from harmful UVR overexposure. Participants supported a need for consistent sun protection messaging across primary schools with greater emphasis on education rather than compliance management to sun protection. CONCLUSION: Enhancing existing teacher education programs to include more rigorous curriculum content and pedagogical approaches to sun protection education is a novel skin cancer prevention strategy and could feasibly support PSTs self-efficacy to effectively deliver sun safety curriculum in Australian schools.

A Photoaging Intervention Delivered to Adolescents in Secondary Schools: A Feasibility Study.

Excessive exposure to ultraviolet radiation during adolescence can have a lasting effect on long-term skin cancer risk. Skin cancer prevention interventions for adolescents have been less commonly investigated than those for children and adults. The study objectives were to develop and evaluate the feasibility of a secondary school-based appearance focused intervention, including the development and testing of protocols and instruments, as a resource module that could be efficiently integrated into the secondary school science curriculum. This longitudinal study was conducted with a convenience sample of 38 13-14 year-old students attending one New Zealand (NZ) urban secondary school. The recruitment rate was excellent with only one student not participating because of parental concern. In terms of the implementation practicality, the intervention, as it stands, was extremely resource intensive, involving four research staff to deliver. This will not work if delivered in a classroom setting by a single teacher. However, the intervention was well received by students, so it shows promise if a less resource intensive version could be produced. The acceptability of the intervention with the students was good with the majority (61%) having no suggestions for improvements. Suggested improvements were minor and could be easily addressed.

What can Aotearoa New Zealand learn from the Australian Sunsmart Story? A qualitative study.

OBJECTIVE: To explore the views of stakeholders in Australia concerning skin cancer primary prevention and identify successful strategies used that may be translatable to other jurisdictions. METHODS: In-depth stakeholder interviews with experts engaged in skin cancer prevention advocacy and action in Australia. RESULTS: A number of important facilitators were identified including: the use of good scientific evidence (including economic), strong leadership, legislation and strategic documents, engaging the media particularly with the use of personal stories and garnering public support. A number of barriers were also identified including: a lack of funding (particularly nationally), variation by state, apathy and the long latency of skin cancer. CONCLUSIONS: Advocates identified a number of key strategies that were used to gain momentum in achieving Australia's comprehensive Sunsmart program. These included: strong leadership, legislation including that banning solaria and workplace health and safety legislation, a critical mass of key advocates from a range of disciplines including clinicians and patients, and the advantageous use of media to drive change. IMPLICATIONS FOR PUBLIC HEALTH: Australia demonstrates what can be achieved when skin cancer prevention is taken seriously. The challenge for other nations is to apply the lessons learnt in Australia to our own jurisdictions.

Estimated Healthcare Costs of Melanoma and Keratinocyte Skin Cancers in Australia and Aotearoa New Zealand in 2021.

Australia and Aotearoa New Zealand have the highest incidence of melanoma and KC in the world. We undertook a cost-of-illness analysis using Markov decision-analytic models separately for melanoma and keratinocyte skin cancer (KC) for each country. Using clinical pathways, the probabilities and unit costs of each health service and medicine for skin cancer management were applied. We estimated mean costs and 95% uncertainty intervals (95% UI) using Monte Carlo simulation. In Australia, the mean first-year costs of melanoma per patient ranged from AU$644 (95%UI: $642, $647) for melanoma in situ to AU$100,725 (95%UI: $84,288, $119,070) for unresectable stage III/IV disease. Australian-wide direct costs to the Government for newly diagnosed patients with melanoma were AU$397.9 m and AU$426.2 m for KCs, a total of AU$824.0 m. The mean costs per patient for melanoma ranged from NZ$1450 (95%UI: $1445, $1456) for melanoma in situ to NZ$77,828 (95%UI $62,525, $94,718) for unresectable stage III/IV disease. The estimated total cost to New Zealand in 2021 for new patients with melanoma was NZ$51.2 m, and for KCs, was NZ$129.4 m, with a total combined cost of NZ$180.5 m. These up-to-date national healthcare costs of melanoma and KC in Australia and New Zealand accentuate the savings potential of successful prevention strategies for skin cancer.

Impact of legislative reform on worker fatalities in New Zealand workplaces: a 30-year retrospective population-level analysis.

OBJECTIVES: To determine the impact of major legislative changes to New Zealand's Occupational Health and Safety (OHS) legislation with the adoption of the Robens model as a means to control occupational risks on the burden and risk of work-related fatal injury (WRFI). METHODS: Population-based comparison of WRFI to workers aged 15-84 years occurring during three periods: before (pre:1985-1992), after legislative reform (post-1:1993-2002) and after subsequent amendment (post-2:2003-2014). Annual age-industry standardised rates were calculated with 95% CI. Multivariable Poisson regression was used to estimate age-adjusted annual percentage changes (APC) for each period, overall and stratified by high-risk industry and occupational groups. RESULTS: Over the 30-year period, 2053 worker deaths met the eligibility criteria. Age-adjusted APC in rates of worker WRFI changed little between periods: pre (-2.8%, 95% CI 0.0% to -5.5%); post-1 (-2.9%, 95% CI -1.3% to -4.5%) and post-2 (-2.9%, 95% CI -1.3% to -4.4%). There was no evidence of differences in slope. Variable trends in worker WRFI were observed for historically high-risk industry and occupational groups. CONCLUSIONS: The rate of worker WRFI decreased steadily over the 30-year period under examination and there was no evidence that this pattern of declining WRFI was substantially altered with the introduction of Robens-styled OHS legislative reforms. Beyond headline figures, historically high-risk groups had highly variable progress in reducing worker WRFI following legislative reform. This study demonstrates the value in including prereform data and high-risk subgroup analysis when assessing the performance of OHS legislative reforms to control occupational risks.

Generating political priority for skin cancer primary prevention: A case study from Aotearoa New Zealand.

ISSUES ADDRESSED: Skin cancer is highly prevalent but preventable, yet little research has been done on the challenges in generating political priority for skin cancer prevention. This qualitative study aimed to identify the political challenges to, facilitators of, and strategies to strengthen skin cancer prevention. The focus was on the case of Aotearoa New Zealand (NZ): a country with high skin cancer rates, but limited investment in primary prevention. METHODS: Data sources included 18 national key informant interviews and documentary analysis. Data were analysed inductively for emerging themes and framed using a conceptual framework of political priority. RESULTS: Challenges to advocates for skin cancer primary prevention include limited resources and competing priorities. Political-level challenges include a lack of quick results compared with other initiatives vying for political attention, lack of negative externalities and, in NZ, misalignment with health system priorities. Challenges in the evidence base include the perceived conflict of sun protection with Vitamin D and physical activity, the lack of data on the financial burden of skin cancer and relatively low temperatures in NZ. Facilitators include strong policy community cohesion and issue framing, and weak opposition. Promising strategies to strengthen skin cancer prevention in NZ could include network building, using framing that resonates with policy makers and addressing key knowledge gaps in NZ, such as the financial burden of skin cancer. CONCLUSION: Advocacy for skin cancer prevention faces challenges due to advocates' limited resources, political challenges such as lack of quick results and gaps in evidence. Nonetheless, the initiative encounters little opposition and can be framed in ways that resonate with policy makers. SO WHAT?: Skin cancer is highly preventable, but advocates for prevention initiatives have struggled to gain political traction. This study identifies several strategies that could help raise the political profile for skin cancer prevention.

Erythemal ultraviolet radiation exposure of high school rowers in Aotearoa/New Zealand.

Athletes who compete in outdoor sports can receive potentially harmful levels of solar ultraviolet radiation (UVR). Rowing is a popular outdoor sport that takes place during the peak UVR season. Using electronic dosimeters attached to the shoulder strap of the rower's uniform, this study aimed to quantify the real-time solar UVR exposure experienced by high school rowers during competition. We measured personal UVR exposure (PE) during the time spent on the water in order to compete in a single rowing-race (race-time), when rowing administrators are responsible for athletes' wellbeing. Data collection took place in Aotearoa (New Zealand) at Lake Ruataniwha (44.28°S, 170.07°E), during two consecutive rowing seasons (December-February 2018-19 and 2019-20). Analysis of dosimeter data generated from 56 race-times over five regattas revealed a median personal UVR exposure (PE) of 1.15 standard erythemal dose (SED), where 1 SED is defined as an effective radiant exposure of 100 Jm-2. Mean race-time was 46 min. Over two-thirds of race-times (69.6%) exceeded the Australian Radiation Protection and Nuclear Safety Agency recommendation of 1 SED being considered safe for most people in a day. An exposure of 1.5-3.0 SED produces perceptible erythema for people with light coloured skin and the lower parameter of 1.5 SED was exceeded in 14 (25.0%) of the race-times. By regatta, the median SED/h ranged from 0.96-2.40 and the median percentage of total concurrent ambient UVR ranged from 17 to 31%. Our results indicate that rowing is a high UVR sport and that races outside of peak UVR times also warrant the use of sun protection even when the UVI < 3. Given that acute and cumulative UVR exposure are recognised risk factors in the development of ocular diseases and skin cancers later in life, risk management guidelines for competitive school rowing will be incomplete until a long-term approach to well-being is considered and comprehensive sun protection measures adopted.

Effectiveness of Sun Protection Interventions Delivered to Adolescents in a Secondary School Setting: A Systematic Review.

AIM: The aim of this systematic review is to summarise the evidence of the effectiveness of interventions targeted to adolescents (13 to 18 years inclusive) and delivered in a secondary school setting with the purpose of improving sun protection behaviour, reducing ultraviolet radiation (UVR) exposure, and/or improving physiological outcomes related to UVR exposure (such as erythema or naevi development). METHODS: Peer-reviewed journal articles were identified from seven database searches (Cochrane, Embase, CINAHL, Scopus, Medline, PsycInfo, and Web of Science) to January 2020, forward citation searches of relevant articles, and monitoring of WHO INTERSUN UVR list server for recent publications. Relevant articles were collected and critically analysed using the Effective Public Health Practice framework. Two reviewers independently reviewed, and when deemed eligible, extracted data and performed quality appraisals for each study. RESULTS: Thirteen studies met the criteria for inclusion in the review. There were no studies that met a "strong" quality rating, five received a "moderate" quality rating, and eight studies a "weak" quality rating. Three of those with a moderate rating found evidence for effectiveness. The most promising interventions overall (including the pilot/uncontrolled studies) were those that moved beyond a pure health education approach and used innovative approaches such as the provision of shade, or use of technology (e.g., appearance-based apps or real-time ultraviolet index (UVI) monitors). CONCLUSIONS: There is a lack of high-quality published studies investigating the interventions delivered in a secondary school setting to protect students from UVR. The evidence could be strengthened if researchers used consistent, standardised outcome measures for sun protection exposure and behaviour. Other factors limiting the strength of evidence were short follow-up times (largely less than 6 months) and/or nonrobust study design.

Decade of fatal injuries in workers in New Zealand: insights from a comprehensive national observational study.

INTRODUCTION: Current priorities and strategies to prevent work-related fatal injury (WRFI) in New Zealand (NZ) are based on incomplete data capture. This paper provides an overview of key results from a comprehensive 10-year NZ study of worker fatalities using coronial records. METHODS: A data set of workers, aged 15-84 years at the time of death who died in the period 2005-2014, was created using coronial records. Data collection involved: (1) identifying possible cases from mortality records using selected external cause of injury codes; (2) linking these to coronial records; (3) retrieving and reviewing records for work-relatedness; and (4) coding work-related cases. Frequencies, percentages and rates were calculated. Analyses were stratified into workplace and work-traffic settings. RESULTS: Over the decade, 955 workers were fatally injured, giving a rate of 4.8 (95% CI 5.6 to 6.3) per 100 000 worker-years. High rates of worker fatalities were observed for workers aged 70-84 years, indigenous Maori and for males. Workers employed in mining had the highest rate in workplace settings while transport, postal and warehousing employees had the highest rate in work-traffic settings. Vehicle-related mechanisms dominated the mechanism and vehicles and environmental agents dominated the breakdown agencies contributing to worker fatalities. DISCUSSION: This study shows the rates of worker fatalities vary widely by age, sex, ethnicity, occupation and industry and are a very serious problem for particular groups. Future efforts to address NZ's high rates of WRFI should use these findings to aid understanding where preventive actions should be prioritised.

Work-Related Fatalities Involving Children in New Zealand, 1999-2014.

In high income countries, children under 15 years of age are exposed to workplace hazards when they visit or live on worksites or participate in formal or informal work. This study describes the causes and circumstances of unintentional child work-related fatal injuries (child WRFI) in New Zealand. Potential cases were identified from the Mortality Collection using International Classification of Disease external cause codes: these were matched to Coronial records and reviewed for work-relatedness. Data were abstracted on the socio-demographic, employment and injury-related circumstances. Of the 1335 unintentional injury deaths in children from 1999 through 2014, 206 (15%) were identified as dying from a work-related injury: 9 workers and 197 bystanders-the majority involving vehicle crashes or being stuck by moving objects in incidents occurring on farms or public roads. Those at highest risk were males, preschoolers, and those of Maori or European ethnicity. Work made a notable contribution to the burden of unintentional fatal injury in children with most deaths highly preventable, largely by adult intervention and legislation. To address the determinants of child WRFI greater attention on rural farm and transport settings would result in a significant reduction in the injury mortality rates of New Zealand children.

Decade of variable progress: trends in fatal injury in workers in New Zealand from a national observational study.

INTRODUCTION: Analyses of secular trends in work-related fatal injury in New Zealand have previously only considered the total working population, potentially hiding trends for important subgroups of workers. This paper examines trends in work-related fatalities in worker subgroups between 2005 and 2014 to indicate where workplace safety action should be prioritised. METHODS: A dataset of fatally injured workers was created; all persons aged 15-84 years, fatally injured in the period 2005-2014, were identified from mortality records, linked to coronial records which were then reviewed for work relatedness. Poisson regression modelling was used to estimate annual percentage change in rates by age, sex, ethnicity, employment status, industry and occupation. RESULTS: Overall, worker fatalities decreased by 2.4% (95% CI 0.0% to 4.6%) annually; an average reduction of 18 deaths per year from baseline (2005). Significant declines in annual rates were observed for younger workers (15-29 and 30-49 years), indigenous Maori, those in the public administration and service sector, and those in community and personal service occupations. Increases in annual rates occurred for workers in agriculture and forestry and fisheries sectors and for labourers. Rates of worker deaths in work-traffic settings declined faster than in workplace settings. DISCUSSION: Although overall age-standardised rates of work-related fatal injury have been declining, these trends were variable. Sources of injury risk in identifiable subgroups with increases in annual rates need to be urgently addressed. This study demonstrates the need for regular, detailed examination of the secular trends to identify those subgroups of workers requiring further workplace safety attention.

Identifying opportunities to prevent work-related fatal injury in New Zealand using 40 years of coronial records: protocol for a retrospective case review study.

BACKGROUND: Improving New Zealand's poor workplace safety record has become a high priority following high profile workplace fatal incidents in 2010 and 2014. Existing routine official data are unable to reliably inform occupational safety policy and action in New Zealand. This case review study will examine work-related fatal injury (WRFI) to: i) determine their burden, rates and distribution; ii) identify high-risk groups, causes and circumstances; iii) analyse secular trends, and iv) examine the impact of historic occupational safety legislative reform. DESIGN AND METHODS: A comprehensive New Zealand WRFI dataset from 1975 to 2014 will be established using existing data for 1975-1994 combined with new data for 1995-2014 extracted from reviewed coronial case files. Data collection involves: 1) identifying likely cases of WRFI from national mortality records using selected injury external cause codes; 2) linking these to coronial case files, which will be retrieved and reviewed to determine work-relatedness; and 3) coding work-related cases. Annual WRFI frequencies and rates will be calculated and disaggregated by age, sex, employment status, occupation and industry to identify high-risk groups and compared across the time series. The circumstances of the WRFIs will be analysed in-depth. The impact of New Zealand's Health and Safety in Employment 1992 Act, which resulted in deregulation of the previous legislative frameworks for occupational health and safety during a period of rapid labour market restructuring, will be examined by comparing rates before and after implementation of the Act. DISCUSSION: The resulting evidence will serve as the basis for policy development and practical interventions to reduce WRFI, targeting groups of high-risk workers, and for bench-marking of workplace safety performance in New Zealand.

Sun protection policies and practices in New Zealand primary schools.

AIM: To assess sun protection policies and practices in New Zealand primary schools. METHODS: Principals at 1,243 schools (62% of eligible primary schools) completed a survey about school: 1) provision of personal and environmental sun protection, 2) sun protection practices. RESULTS: Virtually all schools (94%) had a sun protection policy/procedure about which their community was informed (96%). Nearly three-quarters (72%) allowed only sun-protective hats, 28% allowed caps. Almost all schools either enforced or encouraged student hat wearing outdoors. Three-quarters of schools encouraged students to wear broad-spectrum sunscreen of at least SPF30 and most (93%) provided sunscreen at least some of the time. Three-quarters of schools (74%) had at least sufficient shade for passive activities like eating lunch. CONCLUSIONS: A substantial improvement in sun protection in primary school settings was observed since a previous survey, but sun protection remains inadequate in many schools and vulnerable students throughout New Zealand deserve equitable protection. Skin cancer is New Zealand's most common cancer, but also highly preventable, yet primary prevention in school settings is not resourced from public funds. Appropriate school sun protection policies and practices can potentially reduce students' exposure to excessive UVR and ultimately reduce skin cancer risk.

Recruitment and participant baseline characteristics in the dialysis outcomes in those aged 65 years or older study.

BACKGROUND: Despite an increasing number of older people commencing dialysis the impact of dialysis on their quality of life and survival, remains unclear. The Dialysis Outcomes in those aged over 65 years or older study is an accelerated prospective cohort longitudinal design study, designed to obtain sufficient health related quality of life data, linked to clinical data, to inform clinicians' and patients' decision-making with respect to end stage kidney disease (ESKD), outcomes, and options for management in New Zealand (NZ). METHODS: The study has an accelerated prospective cohort longitudinal design, comprised of cross-sectional and longitudinal components. We report the baseline data on the 225 participants enrolled in the study. Dialysis duration was grouped in tertiles from less than one year (incident patients), 1-3 years and greater than 3 years. Health related quality of life data was obtained from self-reported questionnaires including KDQoL-36, EQ-5D-3 L, FACIT, WHODAS II, and the Personal Well-being Score. RESULTS: The median age of the cohort was 71 years and two thirds were male. Three quarters of the participants were on dialysis at the baseline, with 42% of those on home dialysis (haemodialysis or peritoneal dialysis). Maori and Pacific people were over represented (20% Maori and 24% Pacific) in the sample, when compared to the general NZ population of the same age group (where 5% are Maori and 2% are Pacific). At baseline, there were no differences observed in sociodemographic, quality of life or health characteristics between the dialysis groups either by modality or duration of dialysis. CONCLUSIONS: We report the baseline characteristics of participants enrolled prospectively into a longitudinal cohort observational study examining health related quality of life factors with clinical characteristics on dialysis outcomes in a group of New Zealanders aged 65 years or older who are either on dialysis or have been educated about dialysis (BMC Nephrol 14:175, 2013). Subsequent publications are planned, analysing the prospective longitudinal data to identify key factors that determine both outcome and quality of life for individuals of this age group. TRIAL REGISTRATION: ACTRN12611000024943 .

SunSmart news? Traditional media coverage of sun protection issues during springtime in New Zealand.

ISSUES ADDRESSED: Cutaneous melanomas and keratinocyte carcinomas (nonmelanoma skin cancer) are highly prevalent in New Zealand (NZ), making skin cancer a priority area for cancer control. Spring is an important time for encouraging sun-safety, due to ultraviolet radiation (UVR) levels becoming hazardous. The news media have a potential to play an important role in reminding people and emphasising the importance of sun-safety. This study aimed to describe how the traditional NZ media portrayed sun-safety and skin cancer in spring news stories. METHODS: A media monitoring company collated stories related to cancer during spring 2016. These were reviewed for inclusion and content was coded according to the cancer type described. Stories focused on skin cancer and sun protection issues were coded according to the position on the cancer control continuum. RESULTS: Skin cancer and sun-safety represented 3.6% (n = 110) of all cancer stories published. Stories mainly related to primary prevention (72%), early detection (37%) and survivorship (27%). The main risk factors identified included sun exposure (49%) and tanning (25%). CONCLUSIONS: Traditional media coverage of skin cancer remains relatively low during springtime. It is heartening to see that most stories included prevention information. SO WHAT?: Given the impact of skin cancer in NZ, and the importance of springtime as a period for behaviour change to reduce risk, there is considerable scope for increased media coverage and advocacy. Further research could usefully analyse media trends throughout the year and within specific media platforms, both traditional and new, in order to further disseminate information to the NZ public.