Cancer: Controlled Drug Delivery of 5-ALA and its Esters

The provided content appears to be a collection of articles, journals, and online sources related to cancer research, specifically focusing on skin cancer. The topics covered include the biological effects of curcumin, ultraviolet radiation exposure, cancer-related inflammation, and the causes of skin cancer. Additionally, there are statistics and information on skin cancer mortality rates and prevention methods.

TO ANALYZE CAUSES AND RISK FACTORS OF SKIN CANCER

ABSTRACT
Skin cancers are the ones that are caused in skin cells and may led to their abnormal
growth. They are majorly caused due to exposure to UV radiation that arises from sun rays. The
issue is of concern in UK as there has been an upsurge in skin cancer rates of UK since 1970. As
per the studies, around 1, 00000 new cases of skin cancer are diagnosed every year. The disease
has then a tendency to kill over 2500 people in UK on a yearly basis. Hence the present research
report will thus analyze the causes as well as risk factors of cancer that has caused such an
increase in UK. The UK specific statistics related to skin cancer will be also be discussed and
analyzed. From the report it has been concluded that skin cancer is a major form of cancer in
UK. This is due to high exposure with UV rays found in sun as well as presence of Caucasian
population that have a greater tendency of developing skin cancer. Other than that reduced
clothing, ozone depletion, genetics, lifestyle change are the major risk factors of skin cancer. It
can thus be recommended to adhere with technique related to Sun protection as well as focusing
on early detection for other population who has likelihood to develop skin cancer.

ACKNOWLEDGEMENTS

Table of Contents
CHAPTER 1 INTRODUCTION.....................................................................................................7
1.1 Research project description (brief overview of nature of project)..................................7
1.2 Research Aims and Objectives.........................................................................................7
1.3 Critical review of key references......................................................................................8
1.4 Research methodology......................................................................................................9
1.5 Structure of the project..........................................................................................................9
Chapter 1 introduction – The section will focus on discussing the aims, objective, background
study as well as rationale of selected topic. Focus will also be given carrying out a critical review
of references.....................................................................................................................................9
CHAPTER 2: LITERATURE REVIEW.......................................................................................11
2.1 Introduction..........................................................................................................................11
2.2 Statistics in UK of skin cancer.............................................................................................11
2.3 Causes..................................................................................................................................13
2.4 Risk factors..........................................................................................................................14
CHAPTER 3: METHODOLOGY.................................................................................................15
CHAPTER 4 DATA COLLECTION AND ANALYSIS 1000....................................................19
4.1 Data Collection....................................................................................................................19
4.2 Data Analysis and Discussion.............................................................................................19
5.1 Conclusion...........................................................................................................................22
5.2 Recommendations................................................................................................................22

The present study has been carried on to analyze causes and risk factors of skin cancer.
However, the research has further got scope to focus on making it cause specific. It can be
related to identifying how skin cancer is caused due to presence of ionizing radiations.
Research study can further be done on how arsenic may cause skin cancer. Other than the
topic areas for further research can be Risk reduction for nonmelanoma skin cancer with
childhood sunscreen use............................................................................................................23
Kricker, A., Armstrong, B. K. and English, D. R., 1994. Sun exposure and non-melanocytic
skin cancer. Cancer Causes & Control. 5(4). pp.367-392.........................................................25
Villanueva, M. T., 2015. Tumorigenesis: miRNAs [mdash] novel regulators in skin
cancer. Nature Reviews Cancer. 15(1). pp.5-5..........................................................................26

CHAPTER 1 INTRODUCTION
1.1 Research project description (brief overview of nature of project)
Skin cancers are the ones that arise from skin due to development of abnormal cells. It
begins from normal skin cells that further transform to reproduce in an out-of-control manner.
Unlike other cancers, this type of disease does not have a potential to spread towards other body
part. These cancers include melanoma, basal cell, and squamous cell. Among the skin cancer
types, Melanoma is less command is also not so dangerous in comparison to other variants (Skin
Cancer, 2015). The chosen topic of study is to identify the causes of skin cancer. The rationale
for the same is due to increased incidences of these cancers in UK. As per the studies, around 1,
00000 new cases of skin cancer are diagnosed every year. The disease has then a tendency to kill
over 2500 people in UK on a yearly basis (Skin cancer statistics, 2015). It accounts to every
seven people on a daily basis. The statistics thus clergy show the complexity of issue. In this
regard, these cancers can be treated well if the causes are identified properly.
1.2 Research Aims and Objectives
Aim
To assess the causes and risk factors associated with skin cancer
Objectives
 To analyze the statistics of skin cancer in UK
 To analyze what causes skin cancer
 To identify the population groups that is vulnerable to develop skin cancer
 To suggest strategies for reducing the chances of skin cancer
1.3 Critical review of key references
Armstrong and Kricker, 2001 in there study have pointed out that basal cell carcinoma,
squamous cell carcinoma, and melanoma are caused due to sun exposure. The incidence rate has
further been found to be higher in fair skinned rather than dark skinned people. The study further
recommends to implementing sun protection (Arnmstrong and Kricker, 2001).

Armstrong, 2004 in a study has further agreed that sun exposure is the basic reason for causing,
basal cell, and squamous cell cancer (Armstrong, 2004).
Boffeta, 1997 has reviewed that Heavy exposure to polycyclic aromatic hydrocarbons may led to
skin cancer. The researcher further specifies that increased risk is present in most of the
industries and occupations that has a presence of carcinogenic exposures (Boffeta, 1997).
Freedman, Dosemeci and McGlynn, 2002 carried out a study on mortality from breast, ovarian,
colon, prostate, and non-melanoma skin cancer. It was found that Non-melanoma skin cancer
had a positive exposure with residential and occupational sunlight (Freedman, Dosemeci and
McGlynn, 2002).
Ron and et.al., 1998 made an attempt to study the Skin tumor risk among atomic-bomb survivors
in Japan. It was found that there is an increased sensitivity of basal layer of the epidermis
towards radiation carcinogenesis. This is particularly true for young age children. However, the
suprabasal layer is more resistant to ionizing radiation which is shown by lack of an association
for squamous cell carcinomas (Ron and et.al., 1998).
Ulrike Leiter and Claus Garbe, 2008 carried out a study on assessinb there Role of Sunlight in
Epidemiology of Melanoma and No melanoma Skin Cancer. It was found that risk of squamous
cell carcinoma is linked with exposure to Spiraled and UVA irradiation. Other than that the study
further reveled that intensive UV exposure in childhood as well as adolescence is the major
reason for developing basal cell carcinoma. The study also identified many risk factors like
exposing ultraviolet (UV) light, increased presence of outdoor activities, reduced clothing, more
long life, depletion of ozone layer, genetics as well as immune suppression (Leiter and Claus,
2008).
Kennedy and et.al., 2003 have found that Lifetime sun exposure leads to increased risk of
developing squamous cell carcinoma as well as actinic keratosis. In contrast, lifetime sun
exposure further showed a presence of lower risk of malignant melanoma. It was further found
that lifetime sun exposure did not diminish the number of melanocytic nevi or atypical nevi
(Kennedy and et.al., 2003).

Chen and et.al., 2003 have concluded that subjects with high exposure to arsenic had a presence
of increased risk of skin cancer. It was predominately found in males who were on a high risk
towards skin cancer development in comparison to women (Chen and et.al., 2003).
Saladi and et.al., 2005 have concluded that most common skin cancer cause is due to Ultraviolet
radiation from sun. Other than that Sunburns and excessive exposures leads to cumulative
damage that further induces immunosuppression and skin cancers (Saladi and et.al., 2005).
1.4 Research methodology
Research type – qualitative research type
Research design – Exploratory design
Research approach – Deductive approach
Data collection – secondary data collection
Data analysis – Thematic analysis
1.5 Structure of the project
Chapter 1 introduction – The section will focus on discussing the aims, objective, background
study as well as rationale of selected topic. Focus will also be given carrying out a critical review
of references.
Chapter 2 literature review – The given section will focus on discussing the theories and
concepts with respect to cause and risk factors related to skin cancer.
Chapter 3 methodologies – The chapter will emphases on finding out how proposed research
will be implanted. This will be done by providing an appropriate plan and procedures with
respect to research design, approach, data collection as well as analysis.
Chapter 4 Data collection and analysis – This section will focus on finding out the techniques to
Record and collate the data followed by analyzing the data by make g use of
qualitative/quantitative research techniques.

Chapter 5 Conclusions and recommendation - The chapter will emphasize on concluding the
study followed by making recommendations so as to solve the issue of skin cancer. The areas of
further consideration will also be discussed.

CHAPTER 2: LITERATURE REVIEW
2.1 Introduction
Review of the literature can be defined as a process of analyzing historical research
studies of past researchers. It is beneficial for getting appropriate insights to develop appropriate
assumptions to resolve research problem as well as getting appropriate solution of every research
question. As per the introduction chapter determining causes and risk factors is major aim of the
current investigation (Karin, 2006). Researcher will evaluate different research studies on skin
cancer and different reasons behind these health issues. In addition, the current chapter of
research will comprises the statistical facts and figures of the skin cancer in UK which will help
in determining the actual situation of the country. Further, historical investigation will analyze
different research articles related to the causes of the skin cancer and associated risk factors also.
Therefore, literature on these subjects will provide appropriate guidelines for determining
appropriate research gap and getting appropriate findings for making meaningful conclusion for
the research of cancer causes (Narayanan, Saladi and Fox, 2010).
2.2 Statistics in UK of skin cancer
Skin cancer is a growing problem of the UK and rates are increasing day by day. At least
100,000 new cases are now diagnosed every year and this disease kills approx. 2500 people each
year in the UK means seven people dead due to the skin cancer problem in UK (Yoshinaga,
2005). Earlier, in 1970s only 1800 people faced the problem of skin cancer but recent data has
reflected huge difference between figures. As per the health atlas, major risk of skin cancer is in
the south-west England. As per the guidance of health care professionals, people needs to check
for the signs of skin cancer on a monthly basis. But, survey of British Association of
Dermatologists (BAD) has reflected that 96% people fails to do the regular checkup of skin
cancer (Skin Cancer, 2015). As per the disclosed data risks of contact to the sun has led to
increment in rates of skin cancer. Due to this reason this rate has increased by 41% in UK in last
five years.
Malignant Melanoma is one of the major type of skin cancer because, in 2012 approx.
13497 new cases of malignant melanoma were admitted in health and social care organization of
UK. In which, 2148 people dead due to this skin cancer. In which, 90% people are surviving in
England and Wales but only 86% cases of malignant melanoma can be preventable by health

care professionals of UK. Similarly, health and social care survey has reflected that, 98,400
cases of non-melanoma skin cancer were registered in 2011 in the UK (Skin cancer mortality
statistics, 2015). Statistical facts of Malignant Melanoma for the year 2012 is given as under
which will help in analyzing the causes and risk factors of skin factors for different genders
(Owen, 2015).
Table 1: Statistics of Malignant Melanoma
Malignant Melanoma (C43): 2012
Number of Deaths, Crude and European Age-Standardized (AS) Mortality Rates per
100,000 Population, UK
England Wales Scotland Northern Ireland UK
Male Deaths 1,030 76 115 22 1,243
Crude Rate 3.9 5 4.5 2.5 4
AS Rate 3.1 3.6 3.5 2.3 3.1
AS Rate - 95% LCL 2.9 2.8 2.8 1.4 3
AS Rate - 95% UCL 3.3 4.4 4.1 3.3 3.3
Female Deaths 751 57 75 22 905
Crude Rate 2.8 3.6 2.7 2.4 2.8
AS Rate 1.9 2.4 1.8 1.7 1.9
AS Rate - 95% LCL 1.8 1.8 1.4 1 1.8
AS Rate - 95% UCL 2 3 2.2 2.4 2
Persons Deaths 1,781 133 190 44 2,148
Crude Rate 3.3 4.3 3.6 2.4 3.4
AS Rate 2.4 3 2.6 2 2.5
AS Rate - 95% LCL 2.3 2.5 2.2 1.4 2.4
AS Rate - 95% UCL 2.6 3.5 2.9 2.6 2.6
Statistics of above table has reflected that Malignant Melanoma is one of the major
reason behind the death of 2148 person in UK. In which, 905 person was female and 1243
persons were male. Crude Rate is also high in males as compare to females. Including this, above
data has also reflected that, skin cancer is highly increasing in England, Wales, Scotland and
Northern Ireland of UK. In which most of the cases belong to England (Balkwill, 2009).
Therefore, analysis of the statistical figures have reflected that people of England is facing this
skin cancer problem as compare to other cities.

2.3 Causes
Number of researchers have conducted investigation on skin cancer and different health
care agencies also have research and development departments for finding out major causes of
the skin cancer (Saladi and Persaud, 2005). Research in causes has reflected different causes of
skin cancer which are described as under: Sun radiation: International Agency for Research on Cancer (IARC) is investigating on
skin cancer and it has disclosed that “sun radiation is one of the major reason of skin
cancer” (Holick, 2005). As per this statement, Exposure to solar UV radiation increases
the chances of increasing melanoma and non-melanoma skin cancer (NMSC). As per the
data, 86% of malignant melanoma cases in the UK are linked to solar UV radiation
(Singh and Khar, 2006). Exposure to polycyclic aromatic hydrocarbons (PAHs): It is also one of the major reason
of skin cancer. PAHs are organic compounds containing only carbon and hydrogen which
affect tissues of skin as well as also affect the tone of skin (Askling and et.al, 2005).
Exposure of PAHs is increasing in UK day by day due to the incomplete combustion of
organic materials such as wood and petroleum products, fossil fuels, and coal. So,
increment in PAHs leads augmentation in skin cancer in UK (Lopez and et.al, 2004). High doses of ionizing radiation: Rengarajan and et.al, 2015 has stated that “Ionizing
radiation (IR) is an established cause of non-melanoma skin cancer” (Rengarajan and
et.al, 2015). But, researcher has also stated that risk associated with the ionizing radiation
is not certain. Exposure of this radiation has increased due to the atomic blasts. So, it is
also disclosed as a major reason of skin cancer (Mantovani and et.al, 2008).
 Arsenic exposure: Arsenic is a natural component of the earth’s crust and is widely
distributed throughout the environment in the air, water and land. So, highly exposure of
inorganic arsenic is one of the major reason of the skin cancer which has long term
effects on health of individuals (Arsenic, 2012). Pigmentation changes, skin lesions and
hard patches on the palms and soles of the feet are the major signs of the skin cancer due
to arsenic exposure.
Overall, review of literature has reflected that major causes of skin cancer are Sun
radiation, Exposure to polycyclic aromatic hydrocarbons, High doses of ionizing radiation and
Arsenic exposure.

2.4 Risk factors
Leiter and Garbe, 2008 has concluded that “there are different factors which can increase
the risk of skin cancer and these factors are considered as risk feature for this health issue”
(Leiter and Garbe, 2008). These factor includes fair skin complexion, sun exposure, UV light,
etc. Along with this, increased outdoor activities, changes in clothing style, increased longevity,
ozone depletion and genetics are also increased the risk of skin cancer. On the other hand,
different health care survey has disclosed different other factors which can also augment the
frequency of skin cancer and these comprise immune suppression exposure to artificial UV
radiation (tanning beds and lamps), aging, skin color, diet smoking are attributable risk (Miller,
2005).
Rigel, 2008 has concluded that “People who work outdoor have high risk of the skin
cancer because of the direct contact of sun radiations for long time” (Rigel, 2008). Moreover,
Saladi and Persaud, 2005 has concluded that “Fair skin people have greater risk of skin burn and
pigmentation as compare to the black and brown skinned people” (Saladi and Persaud, 2005).
Including this, Mantovani and et.al, 2008 has asserted that “Regular use of the sunbed and
sunlamps augments the risk of developing different types of skin cancers” (Mantovani and et.al,
2008). Balkwill, 2009 has concluded that “Sunny and high attitude climates increases warmness
in weather so, it can affect the skin of people as compare to those who are living in colder place”
(Balkwill, 2009).
In contrast, Singh and Khar, 2006 has said that “Lifestyle of individuals have changed
day by day in different countries and most of the individuals wear such types of cloths by which
skin can direct contacts with the sun and other risk factors” (Singh and Khar, 2006). It also
increases the contact of skin with the UV rays of sun which rises the risk of skin cancer. , ozone
depletion upsurges the exposures of the ionizing radiation which is the major reason of the
Malignant Melanoma skin cancer so, it is also a risk factor for individuals. Narayanan, Saladi
and Fox, 2010 has stated that “not only external factors can increase the risk of skin cancer but
also internal factors such as genes, heredity and genetic variation also leads the chances of skin
cancer among different generations” (Narayanan, Saladi and Fox, 2010). Therefore, as per the
above statement, genetics is also one of the major risk factor of skin cancer. In the current life
style, drinking and inappropriate diet increases different types of the skin infections which can
lead the role of complex skin cancer issues. Therefore, historical research studies helped in

determining the major causes and risk factors of skin cancer which will help in conducting the
relevant investigation on UK (Miller, 2005).
A chronically suppressed immune system that has been suffering from diseases such as
HIV infection or when a person is undergoing chemotherapy has an increased chance of develop
skin cancer. Other than that People who have a history of one skin cancer have got a 20% chance
to develop a skin cancer in the time span f next 2 years. Other than that intake of
immunosuppressive medications also has a tendency to increase the chances of developing skin
cancer. For example, Cyclosporin A, a calcineurin inhibitor may increase the likelihood of
getting akin caner by about 200 times.
Overall, review of literature has reflected that most of the researchers have conducted
research studies of skin cancer on different countries but no one have completed investigation on
causes and risk factors of skin cancer with respect to UK (Lopez and et.al, 2004). So, author has
chosen the current research subject for whole investigation.
Research gap for the study is that most of the researchers have carried out study on
causes of skin cancer as well as identifying the risk factors. However, none of the researcher has
made the study to be UK specific. Hence, there is a good scope to carry out a study on this topic
by making it in reference to UK.
CHAPTER 3: METHODOLOGY
3.1 Methodology, Methods and Techniques
Research type
It helps in understanding the nature of the study on the basis of which methodological tools are
employed. Two types of research are presented namely qualitative and quantitative. Any research
is said to be qualitative when information is present in non-numeric form and for analysis of the
information themes are formed which represents the overall response provided by the
respondents (Smith, 2008). Through qualitative research better understanding of the topic being
chosen for study is possible and it lets meaning merge from the participants. Moreover, for
collection of important information observation method is generally employed and it supports in
understanding about the behavior of people in the environment. On the other hand quantitative
study totally relies on use of statistics and is based on the hypothesis or theory. Apart from this it

is possible to measure the relationship between two variables. Further, present study conducted
is of quantitative nature when information is present in numeric form and statistical tools are
undertaken for analyzing the overall information present. Selection of research type depends on
the nature of the research. The present study being carried out is qualitative in nature where main
stress is on identifying the causes of skin cancer and risk factors associated with it. Data is
present in non-numeric form which has been obtained from the secondary sources. Due to this
basic reason this study is of qualitative nature rather than quantitative one.
3.2 Sampling
Sampling plays most important role in the research as through this respondents are selected from
the population with the aim to collect information. Further, it depends on the nature of study
regarding the selection of sample size (Sreedharan., 2007). Considering the present study data
has been collected from only secondary sources and therefore, it is not at all possible to select
sample size. Sampling only takes place when primary sources are adopted for collection of
information and in case of secondary sources it is of no use. Therefore, no sample size has been
taken for attaining the aim of the research.
3.3 Data collection (Description of how data would be collected)
Research design –
It supports in knowing the type of research which is being carried out. Different types of research
designs are present which are case study, exploratory, descriptive etc. Descriptive research
design focuses on providing description of the topic being chosen and it leads to in-depth
analysis (Srivastave, 2011). Further, this type of research design is adopted when characteristics
of population has to be described and is beneficial for the entire study. Exploratory as a research
design is also present where main stress is on exploring new ideas by examining a set of
information. Apart from this case study as a design is adopted when the entire research is based
on the case provided on the basis of which analysis is done.
For conducting the present study exploratory as a research design has been adopted where main
focus is on exploring new ideas in order to know what are the causes of skin cancer along with
risk associated with it. This design is most appropriate for the present study and through this
overall objectives set for the research can be accomplished easily. Therefore, this is one of the

main reasons behind selection of exploratory design and other designs have not been considered
in the study.
Research approach –
Two types of approaches are present which are used in the study and they are inductive and
deductive (Patton, 2005). In inductive approach results move from specific to general and vice
versa in deductive one. Considering the present study deductive approach has been employed
where findings are based on causes of skin cancer and same can be applied on specific healthcare
organization operating.
Data collection –
In every study data collection plays most significant role as information is collected from the
sources present in order to attain aim of the study. Two sources of data collection are present
which are used in the research and they are primary and secondary. Primary information is
collected for the first time and the information obtained with the help of this source is not used in
any study (Neuman, 2005). This source of data collection is regarded to be most effective as
information is not at all used earlier and this in turn enhances reliability along with validity of the
research. For collection of primary information questionnaire as a tool is used and through this it
is possible to focus on the aim of research. On the other hand secondary data is already published
and is used in different studies in past. Information obtained with the help of this source provides
base to the entire research and expected findings can be attained easily.
Further, for obtaining secondary data different books, journals and online articles are considered
which are associated with the study and they are beneficial for research in every possible
manner. Therefore, these two sources are most commonly adopted for collection of crucial
information and through this it becomes easy to accomplish aim of the research.
Data analysis –
It is also regarded as one of the most important part of the study as through proper analysis
expected results can be attained easily. Two techniques of data analysis are present which are
qualitative and quantitative. In case of qualitative technique information is analyzed by forming
different themes and it represents overall response provided by the respondents (Kumar, 2002).
Further, when quantitative technique is adopted then for data analysis statistical tools are

employed where mean, mode and median is calculated for the information collected. Therefore,
both these tools are most commonly adopted for analyzing the important information and
selection of specific technique of data analysis depends on the nature or type of study which is
being undertaken.
For conducting the present study qualitative technique has been employed where different
themes have been formed on the basis of secondary information obtained. By forming different
themes it is possible to know about the actual causes of skin cancer. Data obtained through
books, journals and online articles has been represented with the help of themes and through this
it is possible to gain expected findings. The reason behind non acceptance of qualitative
technique for data analysis is that information is present in non numeric form and in such case it
is not at all possible to apply statistical tools for analyzing information in the research.
3.4 Ethical considerations
Ethics play significant role in the study as it is regarded as the branch of knowledge which deals
with moral principles. It supports in knowing what is right or wrong and is considered in every
type of research (Kumar and Phrommathed, 2005). Different type of ethical issues are present
which may arise in research such as risk or hazard to researcher and other individuals who are
participating in the study, confidentiality issues where sometime it is possible that primary
information collected from the respondents can be accessed by third party and it is not in favor of
the study which is being carried out.
In the present study researcher has taken corrective actions in advance so as to deal with
ethical issues. Information has been obtained from only secondary sources due to which very less
number of ethical issues is present in the study. Secondary information has been obtained from
the authentic sources which are valid. Further, information published after the year 2000 has
been taken into consideration. Moreover, the data present in other studies has not been used and
if considered it has been modified so that validity along with reliability of the entire study may
not be adversely affected due to this.

CHAPTER 4 DATA COLLECTION AND ANALYSIS 1000
4.1 Data Collection
Data collection in present study has been done by making use of secondary research. The
selection has been justified on the basis of topic being causes and risk factors of skin cancer.
4.2 Data Analysis and Discussion
Skin cancer is caused by exposure to sun rays
The secondary data studies have revealed that exposure to sun rays causes skin cancer.
This is as sun rays have a presence of UV radiation that causes skin cancer. However, it is not
true for all areas. It can further be analyzed that the UV radiation exposure depends on Ozone
depletion in the region, level of UV light weather conditions. It is as these factors affect the UV
radiation that reaches the earth's surface. Moreover, exposure to sun is also required so as to get
Vitamin D.
Skin cancer rate is higher for fair skinned people
Anyone can develop the tendency of skin cancer but it is more common in fair skinned people.
This is due to presence of less melanin pigment that serves as a protection. However it is also
true that people with darker skin can still get skin cancer. In this regard, it can be recommended
that the need for light skinned people is to be cautious about the sun and undertake regular
examination with doctor.
Heavy exposure to polycyclic aromatic hydrocarbons (PAHs)may led to skin cancer
Secondary data has revealed that 50 percent of skin cancer is due to exposure with materials
containing PAHs (Boffeta, 1997). These are inclusive of tars, pitches, soot. This is particularly
true for professions like oil refinery workers, road pavers, jute workers, mule spinners that are
likely to be exposed with PAH. However it is further true that not all PAHs may be carcinogenic
in nature.
Skin tumor risk is high among atomic-bomb survivors in Japan
The literature studies have made a revelation that Skin tumor risk is very high for those who
survived the atomic-bomb attack in Japan (Ron and et.al., 1998). This is as there bodies were

exposed to high amount of ionizing radiation which is the major cause of skin cancer. It has
further been analyzed that even a low to medium doses to exposure to ionizing radiation can
cause skin cancer. Hence, this makes people of Japan living in UK especially the survivors of
atomic attack to be high for skin cancer.
High exposure to arsenic had a presence of increased risk of skin cancer.
From the above literature review it has been found out that arsenic has been causing skin cancer
in exposed population. The common type of skin cancer caused by arsenic is SCC and BCC. It
has further been found form literature studies that skin cancer may develop even 20 years after
the person has been exposed to arsenic (Develop Skin Cancer Due to Pollution Exposure, 2015).
England has maximum skin cancer
From the secondary data it can be analysed that malignant melanoma is the fifth most
common cancer in the UK. There has been an increase in the incidence rates of malignant
melanoma by around half or 49 per cent (Skin cancer statistics, 2015). In the year 2012, there
were around 11, 281 cases of malignant melanoma in England. South west England has the
highest rates of skin cancer for both males and females.
Males are more prone to skin cancer
From the secondary data it can be analysed that men are two times more prone to basal
cell cancers as compared to women. They are also 3 times as likely to suffer from squamous cell
cancers of the skin. It can be analysed that the reason behind this could be more time spent by
men under the sun (Villanueva, 2015). It has also been proposed that men may be more prone to
skin cancer as their skin is more sensitive to sun. in order to solve this health issue, there is a
need to provide male skin with more anti oxidants.
Organ transplant recipients and AIDS patients have an increased incidence of skin cancers
On analysing the secondary data, it can be said that the incidence of skin cancer is higher
in organ transplant recipients and AIDS patients. Likely reason behind this could be increased
exposure to radiation. AIDS patients have a weakened immune system. Same is the case with
people who have undergone an organ transplant. These patients are given medications to
suppress their immune systems so that they do not attack the donated organ as a foreign invader

(Lomas, Leonardi‐Bee and Bath‐Hextall, 2012). This is the reason for higher incidence of non-
melanoma skin cancer.
Females had greater knowledge and stronger intentions to prevent skin cancer than males
Analysis of the secondary data shows that females have greater knowledge and stronger
intentions to prevent skin cancer as compared to males. Females also involve in fewer risk taking
behaviors. Moreover, females have a heightened sense of susceptibility to skin cancer. Also,
females habitually use recommended combination of skin protection (Euvrard and et.al., 2012).
However, the males are not motivated to use sun protection. They also show a risk taking attitude
to their health. As a result of this, they are likely to make less use of sun sun protection.
CHAPTER 5: CONCLUSIONS AND RECOMMENDATIONS 500
5.1 Conclusion
From the research, it can be concluded that skin cancer is the most common form of
cancer in UK. England has the highest rates of skin cancer as compared to other regions. It is
caused by exposure to sun rays. The rate of skin cancer is higher for people who are fair skinned.
Heavy exposure to polycyclic aromatic hydrocarbon may also lead to skin cancer. Atomic bomb
survivors in japan have been found to have a higher risk of skin tumour. Apart from that, the
major reason for developing basal cell carcinoma is intensive exposure to UV rays in childhood
as well as adolescence. The risk of skin cancer increases due to high exposure to arsenic.
Females are known to have a greater knowledge abut the disease. They also possess stronger
intentions as organ transplant recipients and AIDS patients have weakened immune sysems, the
incidence of skin cancer is higher in them.
5.2 Recommendations
In light of the conclusion, it can be said that prevention of exposure to UV rays is the best
method of preventing the development of skin cancer. However, there is scope for some
recommendations. In this regard, the following recommendations can be given:

Sun protection- It is recommended to protect one self from sun while out during the
afternoon. This is because, the best prevention measure for skin cancer is reducing
exposure to the UV rays of the sun.
Campaigns for prevention- There is a need to increase awareness about skin cancer. For this,
it is recommended to launch campaigns for prevention of skin cancer (De Craene and
et.al., 2014). These should aim at raising awareness of people about skin cancer, its
causes and prevention strategies.
Early detection- In order to address the problem of skin cancer, it is recommended that early
detection should be facilitated. People should be encouraged to focus on early detection
so that appropriate treatment can help in controlling the condition. Late detection of
melanoma makes it fatal and difficult for the health care professionals to treat the
condition.
Development of future sun protection agents- There is a need for development of better sun
protection agents and strategies. These can be guided by a better understanding of
mechanisms which allow cutaneous ultraviolet radiation to induce neoplasia (Long and
et.al., 2012).
Regular examination- It is recommended that light skinned people are should be more
cautious of the sun. they should undergo regular examinations by a doctor.
Reduced exposure to polycyclic aromatic hydrocarbons (PAHs)- PAHs may cause skin
cancer (Lee and et.al., 2013). It is therefore recommended to avoid exposure to these
materials.
Avoid tanning and UV tanning beds- These should be avoided as these are associated with
an increased risk of skin cancer.
5.3 Future consideration
The present study has been carried on to analyze causes and risk factors of skin cancer. However,
the research has further got scope to focus on making it cause specific. It can be related to
identifying how skin cancer is caused due to presence of ionizing radiations. Research study can
further be done on how arsenic may cause skin cancer. Other than the topic areas for further
research can be Risk reduction for nonmelanoma skin cancer with childhood sunscreen use.

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