Excessive Exposure to UV Rays Causes Melanoma in Australian Population

This assessment discusses the excessive exposure to UV rays causing melanoma in the Australian population. It explores the causes, prevention, and the need for evidence-based nursing practice.

Introduction
This assessment aids to discuss the excessive exposure to UV rays causes melanoma in the
Australian population. Australia is the country which accommodates more people with
melanoma. According to the recent statistics, out of 3 Australians, 2 are diagnosed with the
melanoma. Men are the high risk group to get affected by the disease condition than women.
Increased rate of melanoma in Australia is due to the skin type they acquire which is not
appropriate for the climate and environment. Other causes for the increased melanoma cases
in Australia are the tanning beds. Recent research proves that the people who had extensive
exposure to the ultra violet rays in the tanning cubicle developed a specific type of skin
cancer called melanoma (Watts 2018). In the year of 2014, the Australian government
banned the commercial tanning beds when new cases and continuous deaths reported with
melanoma. However, this paper argues that the UV ray exposure through tanning beds is
reduced whereby the melanoma rate is still not significantly reduced with the supporting peer
viewed research journals and Meta analysis.
Topic Identification
Melanoma is a common type of skin cancer among Australian. It is categorised as 19th
common skin cancer that affects the world population. Statistical studies done in the year
2018 states that about 40.4% of men in the Australian population are affected by
melanoma (Guitera 2019). About 13,280 new cases are discovered and 1,770 are dying
of melanoma every year. Melanoma is the skin cancer associated with serious
complications. Pigment generating cells in the body multiply and develop as cancerous
cells. Melanoma is commonly found among people with dark skin. It is the less common
skin cancer when compared to other types of skin cancers, but metastasize is fast and it
can affect all the neighbouring organs (Savoye 2017). Cancer council and the health

department of prioritizing melanoma as a national health problem and working towards
to control and cure.
Another factor that is believed to be the causative factor for melanoma is the country’s
geo-location which resides with closer proximity of the South Pole of the globe. The
ozone layer in the South Pole has a hole which allows the UV rays without filtering,
which increases the exposure. Cancer council of Australia conduct various awareness
programs to control melanoma (Sample 2018). Social websites of the cancer council are
added with new preventive measures of melanoma. National Skin Cancer Action Week
is conducted by the cancer council to alert people about one of the dangerous skin cancer
found among Australians. Since melanoma is considered to be the dangerous skin cancer
with fast metastasises, prevention is the only method to control the disease condition.
The health department of Australia and the cancer council create awareness among
schoolchildren to prevent the little citizens from the dreadful disease (Lindqvist 2016).
In spite of the efforts taken by the government of Australia, the melanoma cases are not
reduced significantly. Because excessive exposure to UV rays is one of the causes of
melanoma incidence. The disease condition holds many reasons to emerge in an individual.
Fair skin, family history, age, gender, weak immune system, light coloured hair, history of an
organ transplant are other common causes believed to be causing melanoma. Cancer council
upholds the excessive UV exposure as the cause for the melanoma (Watts 2017). The
government of Australia and cancer council is not focussed on all the causative factors of
melanoma. Because most of the literature based evidence confirms that excessive exposure is
the major cause of melanoma. Research scholars have not taken interest to study on the other
causative factors of melanoma especially about the hereditary nature of the skin cancer. Since
hereditary may increase the number of Australian citizens affected with melanoma.

Melanoma is the skin cancer which causes nightmares to the people, because of the nature of
illness, complications, treatment, and survival after the course of treatment. Due to the
painful course of treatment and complication, people prefer prevention better than cure.
Cancer council of Australia recommends support shade for children, and sun protection
materials like sun glass, proper clothing, and sunscreen (Adler 2019).It also recommends the
people to avoid sun exposure from 10 is till 3 pm which is considered to be a difficult task for
people who work under the sun. People involved in construction, agriculture, farming, traffic
police, and people in road works cannot avoid sun exposure (Trakatelli 2016). People who
are prone to UV ray exposure can use sun protective materials and sunscreen to prevent the
skin from melanoma. Ottawa Charter for health promotion created awareness about ill effects
of UV rays, the importance of sun protection, support shade for children, and sun protection
materials like sun glass, proper clothing, and sunscreen.
A nurse has to be aware of the health issue that significantly affects the major population of
the country. Melanoma is the skin cancer affects most of the Australian citizens. Every year
new cases are discovered and death caused by the dreadful disease also increases. Research
study on the cause of the disease condition improves the clinical knowledge on the specific
disease condition and encourages implementing the literature based nursing intervention in
the nursing practice (Cleaver 2016). It improves the knowledge about the critical analysis of
the diseases condition supported by the literature review. Knowledge gained will help the
nurse to provide quality nursing care.
Evidence Based practice
Primarily, Health care professionals handle the lives of many people, thus the actions
towards the prevention and health promotion have to be an evidence practice. Evidence
based practice in nursing care is implementing the nursing action with the rational that is

supported by the research evidence. Evidence based practice is the updated formula of
the nursing care which improves the clinical knowledge of the nurse and the health of the
patient. All the nursing interventions are supported by the rationale which helps the nurse
to be aware of the action and the reaction. Evidence based nursing practice prevents
failure and errors (Ellis 2019). Medical expertise formulates the evidence based nursing
practice to implement in the patient cares which are practiced for the speedy recovery of
the patient. A nurse can implement the evidence based nursing practice according to self
perception or with the patient’s point of view.
Searchable Clinical Question
The clinical question can be formulated with the support of PICO the clinical question
formula which focuses on the outcome. It is commonly used in the health care industry
for the research purpose. The affected population is stated as adults with the age ranging
from 30-60 years (Sinclair 2018). The intervention to prevent melanoma is to reduce the
exposure to UV rays. Comparison of the study is done with the people who had less
exposure to the UV rays. The outcome is the prevention of melanoma.
P (Population) = adults with 30-60 years
I (Intervention) = No UV exposure
C (Comparison) = more UV exposure
O (Outcome) = prevention of melanoma
Population Intervention Comparison Outcome
adults with
30-60
years
No UV
exposure
More UV
exposure
prevention
of

melanoma
Grown up
adults
Less contact
with UV rays
Excessive
exposure of UV
rays
Control of
melanoma
Middle age
population
Reduced
exposure to
sunlight
More exposure
to sunlight
Prevent skin
cancer
Research Question:
Does the less exposure to the UV rays from sunlight reduce the chances of getting
affected with melanoma compared with people who had excessive exposure in the
Australian population?
Literature Search Strategy
I chose MEDLINE, Medical literature Analysis and Retrieval System Online database to
search the systemic reviews on the melanoma and the causative factor, UV rays.
MEDLINE is the data base which holds the evidence based reviews on health sciences
and academic journals that covers nursing and medical science. MEDLINE database is
widely used by most health professionals in the universe. The key words used are
melanoma in the Australian population, melanoma causes. The other key words used are
“UV rays”, “melanoma” and “causes”. Boolean search is implemented using “OR” and
“AND”; “UV rays and melanoma”, “melanoma or fewer UV rays Exposure”, “Skin
cancer and Causes “Melanoma and preventive measures”.

Pub Med is the database that provides Full text of the journal for free. It has journals of
life science and medical at the U.S National Library of medicine (Sample 2018).
MEDLINE is the part of pub med which holds millions of journals and articles which
benefits many health professionals. Key words used are “melanoma” “skin cancer”
“melanoma prevention”, “melanoma causes” and “avoid skin cancer”. The journal search
can be narrowed by using the refine criteria, publication date, desired language, full text,
citation information. Since pub med data base has millions of journals and an article
finding an article for any nursing and medical search is possible. Boolean search is
implemented using “OR” and “AND”; “UV rays and skin cancer”, “melanoma and
causative factors”, “Skin cancer and prevention “Melanoma and preventive measures”.
I used CINAHL, to search for the systemic reviews on the excessive exposure to the UV
rays causes melanoma. CINAHL is The Cumulative Index to Nursing and Allied Health
Literature. CINAHL is the database widely used by the health professionals and who
pursue a medical or health sciences degree. The key words used are “skin cancer” and
“melanoma prevention”. Truncations are used to narrow the search using “melanoma:
causes”, “Skin cancer: prevention “UV exposure: complications”.
Database Search terms Results
MEDLINE UV rays, melanoma,
causes, UV rays and
melanoma, melanoma or
less UV rays, Exposure,
Skin cancer and Causes,
Melanoma and
preventive measures,
156
Pub Med Melanoma, skin cancer, 205

melanoma prevention,
melanoma causes, avoid
skin cancer, UV rays and
skin cancer, melanoma
and causative factors,
Skin cancer and
prevention, Melanoma
and preventive measures
CINAHL skin cancer, melanoma
prevention, melanoma:
causes, Skin cancer:
prevention, UV
exposure: complications
188
Highest Possible Level of Evidence
A scientific research study argues that excessive exposure to UV rays in tanning booths
causes melanoma. The study is reliable and based on the experimental examination. About
227,888 persons from 30 countries were chosen for the study. Out of that, 14, 5980 persons
from 16 countries underwent multivariate analysis. The study proves that excessive exposure
to ultraviolet rays increases the risk of melanoma (Suppa 2019). The clinical findings of the
study argue that the individuals who used tanning beds for a longer duration have developed
the melanoma. This study proves that the cause for melanoma among the Australian
population is the excessive exposure of UV rays. This study is closely related to the chosen
topic and it supports the argument.

Kumar’s systemic review states that excessive exposure to UV rays causes melanoma. It
discusses the causative factors of melanoma and proves that about 60-70% of melanomas are
caused due to the excessive exposure to UV rays either naturally or artificially causes
diseases condition. It states that there are two types of UV rays that cause melanoma.UVA
and UVB are two types of UV rays found in sunlight. UVA Rays are widely used in tanning
booths which is 12 times more than that from sun. UVB from the sun directly damages the
skin and induces cancer. UVA and UVB found to be causing melanoma in rats. This study is
closely related to the chosen topic and it supports the argument (Kumar 2015).
According to Berwicks review most of the skin cancers are preventable. But melanoma is in
the list of inevitable diseases as the cause is from the natural source. He states that excessive
exposure to UV rays from the sunlight cause melanoma in world population. There are three
common skin cancers that affect human beings; they are basal cell carcinoma, squamous cell
carcinoma, and melanoma (Berwick 2016). Out of these three skin cancers melanoma has a
high death rate. He argues that melanoma can be prevented by implementing precautionary
measures. This study is closely related to the chosen topic and it supports the argument.
Gandinis study (2016) on UV light exposure and its complications is the experimental study.
During a specific course of time, information was gathered from 2,738 individuals affected
with melanoma. Out of that large group, 29% of people are already diagnosed with
melanoma. On observation, the people diagnosed with melanoma had sun exposure during
their holidays 5 years before being diagnosed. The study proves that people who are exposed
to excessive sunlight are prone to skin cancer called melanoma. This study is closely related
to the chosen topic and it supports the argument.
Conclusion

Melanoma is a common type of skin cancer that affects Australian citizens significantly. In
spite of awareness programmes and banning of commercial use of tanning booths, diagnosis
of new cases and death rates are high. Geo-location also contributes to the incidence.
Prevention of exposure to the UV rays is the simplest and cost effective way to escape from
the dreadful skin cancer. According to the advice of cancer council of Australia, be aware of
the importance of support shade for children, and sun protection materials like sun glass,
proper clothing, and sunscreen.
References
Watts, C.G., Drummond, M., Goumas, C., Schmid, H., Armstrong, B.K., Aitken, J.F.,
Jenkins, M.A., Giles, G.G., Hopper, J.L., Mann, G.J. and Cust, A.E., 2018. Sunscreen use and
melanoma risk among young Australian adults. JAMA dermatology, 154(9), pp.1001-1009
https://jamanetwork.com/journals/jamadermatology/fullarticle/2687549
Guitera, P., Collgros, H., Madronio, C.M., Goumas, C., Mann, G.J., Watts, C.G., Pereira,
A.R., Armstrong, B.K., Drummond, M., Morton, R.L. and Scolyer, R.A., 2019. The steadily
growing problem of lentigo maligna and lentigo maligna melanoma in Australia: Population‐
based data on diagnosis and management. Australasian Journal of Dermatology, 60(2),
pp.118-125 https://onlinelibrary.wiley.com/doi/abs/10.1111/ajd.12928
Savoye, I., Olsen, C.M., Whiteman, D.C., Bijon, A., Wald, L., Dartois, L., Clavel-Chapelon,
F., Boutron-Ruault, M.C. and Kvaskoff, M., 2017. Patterns of ultraviolet radiation exposure
and skin cancer risk: the E3N-SunExp study. Journal of epidemiology, p.JE20160166
https://www.jstage.jst.go.jp/article/jea/advpub/0/advpub_JE20160166/_article/-char/ja/

Sample, A. and He, Y.Y., 2018. Mechanisms and prevention of UV‐induced
melanoma. Photodermatology, photoimmunology & photomedicine, 34(1), pp.13-24
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5760354/
Lindqvist, P.G., Epstein, E., Nielsen, K., Landin‐Olsson, M., Ingvar, C., and Olsson, H.,
2016. Avoidance of sun exposure as a risk factor for major causes of death: a competing risk
analysis of the Melanoma in Southern Sweden cohort. Journal of internal medicine, 280(4),
pp.375-387 https://onlinelibrary.wiley.com/doi/full/10.1111/joim.12496
Watts, C.G., Madronio, C., Morton, R.L., Goumas, C., Armstrong, B.K., Curtin, A., Menzies,
S.W., Mann, G.J., Thompson, J.F. and Cust, A.E., 2017. Clinical features associated with
individuals at higher risk of melanoma: a population-based study. JAMA
dermatology, 153(1), pp.23-29 https://jamanetwork.com/journals/jamadermatology/article-
abstract/2580297
Kumar, R., Deep, G. and Agarwal, R., 2015. An overview of ultraviolet B radiation-induced
skin cancer chemoprevention by silibinin. Current pharmacology reports, 1(3), pp.206-215
https://link.springer.com/article/10.1007/s40495-015-0027-9
Trakatelli, M., Barkitzi, K., Apap, C., Majewski, S., De Vries, E., EPIDERM group,
Coebergh, J.W., Apalla, Z., Ioannides, D., Kalabalikis, D. and Kalokasidis, K., 2016. Skin
cancer risk in outdoor workers: a European multicenter case–control study. Journal of the
European Academy of Dermatology and Venereology, 30, pp.5-11
https://onlinelibrary.wiley.com/doi/full/10.1111/jdv.13603
Cleaver, J.E., Ortiz‐Urda, S., Gulhar, R., T. Arron, S., Brookes 3rd, L. and Mitchell, D.L.,
2016. Ultraviolet radiation carcinogenesis. Holland
‐Frei Cancer Medicine, pp.1-8
https://onlinelibrary.wiley.com/doi/abs/10.1002/9781119000822.hfcm026

O’Sullivan, D.E., Brenner, D.R., Demers, P.A., Villeneuve, P.J., Friedenreich, C.M., King,
W.D. and ComPARe Study Group, 2019. Indoor tanning and skin cancer in Canada: A meta-
analysis and attributable burden estimation. Cancer epidemiology, 59, pp.1-7
https://www.sciencedirect.com/science/article/pii/S1877782118306453
Berwick, M., Buller, D.B., Cust, A., Gallagher, R., Lee, T.K., Meyskens, F., Pandey, S.,
Thomas, N.E., Veierød, M.B. and Ward, S., 2016. Melanoma epidemiology and prevention.
In Melanoma (pp. 17-49). Springer, Cham https://link.springer.com/chapter/10.1007/978-3-
319-22539-5_2
Nahar, V.K., Ford, M.A., Brodell, R.T., Boyas, J.F., Jacks, S.K., Biviji-Sharma, R., Haskins,
M.A. and Bass, M.A., 2016. Skin cancer prevention practices among malignant melanoma
survivors: a systematic review. Journal of cancer research and clinical oncology, 142(6),
pp.1273-1283 https://link.springer.com/article/10.1007/s00432-015-2086-z
Adler, N.R., Kelly, J.W., Guitera, P., Menzies, S.W., Chamberlain, A.J., Fishburn, P., Button‐
Sloan, A.E., Heal, C., Soyer, H.P. and Thompson, J.F., 2019. Methods of melanoma detection
and of skin monitoring for individuals at high risk of melanoma: new Australian clinical
practice. Medical Journal of Australia, 210(1), pp.41-47
https://onlinelibrary.wiley.com/doi/abs/10.5694/mja2.12033
Sinclair, C., Wilson, L.F., Olsen, C. and Nicholson, A., 2018. Prevention of Cutaneous
Malignant Melanoma. Melanoma, pp.1-16 https://link.springer.com/content/pdf/10.1007/978-
1-4614-7322-0_34-1.pdf
Ellis, P., 2019. Evidence-based practice in nursing. Learning Matters
https://books.google.co.in/books?
hl=en&lr=&id=hnWKDwAAQBAJ&oi=fnd&pg=PP1&dq=Elements+of+Evidence+based+p

ractice+nursing&ots=prsXISMmUt&sig=ZwdyOczvVjO-
9HFAZNs_zGCIIQQ&redir_esc=y#v=onepage&q=Elements%20of%20Evidence%20based
%20practice%20nursing&f=false
Suppa M, Gandini S, Njimi H, Bulliard JL, Correia O, Duarte AF, Peris K, Stratigos AJ,
Nagore E, Longo MI, Bylaite‐Bucinskiene M. Association of sunbed use with skin cancer
risk factors in Europe: an investigation within the Euromelanoma skin cancer prevention
campaign. Journal of the European Academy of Dermatology and Venereology. 2019
Mar;33:76-88 https://onlinelibrary.wiley.com/doi/full/10.1111/jdv.15307
Gandini, S., Montella, M., Ayala, F., Benedetto, L., Rossi, C.R., Vecchiato, A., Corradin,
M.T., De Giorgi, V., Queirolo, P., Zannetti, G. and Giudice, G., 2016. Sun exposure and
melanoma prognostic factors. Oncology letters, 11(4), pp.2706-2714 https://www.spandidos-
publications.com/10.3892/ol.2016.4292