Prevention updates

Each month we'll share news about cancer prevention and care pathways designed to be shared with PHN providers you support.

 

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April 2024 news and updates

Latest expert advice around the risks and benefits of sun exposure according to different skin types  

A new position statement released by an expert group led by QIMR Berghofer Institute and the University of Queensland has revised recommendations for sun exposure and sun protection advice for adults living in Australia. Acknowledging the diversity of the Australian population and the role of skin type1 in moderating the risks and benefits of sun exposure, the same advice cannot apply completely to everyone. New advice has been tailored specifically with this in mind.  

 A young woman and a young boy together in the playground wearing sun protection

A summary of the position statement regarding risks and benefits of sun exposure

1. Overexposure to UV radiation from the sun causes harm.   

Australia has the highest incidence rate of skin cancer in the world. It is estimated that most of the disease burden from both melanoma and keratinocyte skin cancers is attributed to sun exposure and Australia’s high ambient UV radiation levels.   

Apart from skin type, there are several other factors that influence skin cancer risk including individual sun exposure behaviour, a past personal or family history of skin cancer, immunosuppression, and the presence of multiple naevi.  

People with paler and more sun-sensitive skin types are at higher risk of skin cancers, conversely, people with darker skin that rarely or never burns, are at low risk of solar UV radiation harms. 

2. UV radiation from the sun provides several important health benefits

These include the well-established benefit of vitamin D synthesis by the skin. Vitamin D is recognised in playing a crucial role in musculo-skeletal health and is increasingly associated with other health benefits.  It is acknowledged that Vitamin D deficiency is not uncommon in Australia and that risk of deficiency varies according to skin type.   

Individuals with darker, deeply pigmented skin are more likely than other groups to experience vitamin D deficiency. 

Recommendations regarding sun exposure and sun protection (noting advice should not be the same for everyone)

The revised guidance stratifies individuals into three groups, based on skin type. Guidance is described for each risk group to reduce sun exposure-induced cancer risk while optimising UV exposure benefits.  

For people at highest risk of skin cancer and at intermediate risk of skin cancer (skin types I-II and III-IV on the Fitpatrick scale, corresponding to light or olive skin), sun protection remains the priority. People in these groups should apply sunscreen and use other forms of sun protection on all days when the UV index is forecast to reach 3 or greater and should not spend time outdoors deliberately to maintain adequate vitamin D status. 

People at lowest risk of skin cancer (skin types V and VI on the Fitzpatrick scale corresponding to dark brown or black skin) are advised where possible to spend sufficient time outdoors to achieve and maintain vitamin D status and do not need to apply sunscreen routinely, unless outdoors for extended periods. For people in this risk group sunburn can still occur if outdoors for extended periods and exposure to the sun also causes photoaging. Sunglasses should be worn outdoors to protect the eyes. 

The expert group have summarised risk stratified advice in a detailed table that can be found on page 4 of the full document.

Skin cancer prevention must remain a priority

Importantly, due to the high burden of disease attributed to sun exposure in Australia, the expert group reinforces the need for a sustained focus on skin cancer prevention. For all except those with the darkest skin types, routine sun protection is advised using the 5 SunSmart steps when outside if the UV Index is 3 or above. For most areas of NSW, this is most of the year. 

The Cancer Institute NSW will sustain a primary prevention focus on UV protection and will also update our website information so that people, with dark or deeply pigmented brown to black skin, who have low risk of skin cancer, know to discuss the risks and benefits of sun exposure with their GP. 

Note, this advice has been developed for adults and as such does not directly apply to children.  

Related resources

Footnotes: 

1 Skin type refers to categories based on the Fitzpatrick system. The Fitzpatrick skin phototype system is commonly used to describe a person’s skin type in terms of response to ultraviolent radiation. The scale runs from Type I to Type VI. Type I being the palest skin, most sensitive to sun that always burns and never tans, Type 6 being deeply pigmented dark brown to black skin which never burns. See FitzpatrickSkinType.pdf (arpansa.gov.au) 

 

NSW Quitline: what service does it provide and how can I refer my patients? 

NSW Quitline is a confidential telephone information and counselling service helping people who smoke and vape quit and stay quit. The service is managed and now operated by the Cancer Institute NSW.  

Quitline logo

The NSW Quitline service operating hours are 8am-8pm Monday to Friday, 9am-5pm on Saturdays. If calling outside of these hours, a client’s phone number can be left for a call back from a Quitline counsellor in operating hours.   

Quitline Counsellors are trained professionals who can: 

  • Support clients plan and prepare to quit  
  • Listen and ask about triggers to smoke/vape and motivations to quit  
  • Offer advice about strategies and resources to quit  
  • Help motivate clients to stay on track  
  • Offer regular counselling calls to support clients during and after their quit attempt 

Quitline is available for everyone, clients do not need to be ready to quit to talk to Quitline.  Quitline counsellors can help people plan and prepare for quit attempts.  There are Aboriginal and bilingual counsellors available, and interpreters can be arranged via Telephone Interpreting Service. 

Quitline Counsellors are trained to work with priority populations: 

  • Pregnant people 
  • People living with mental illness 
  • Aboriginal people 
  • People from culturally and linguistically diverse backgrounds 
  • People living with cancer 
  • People in and recently released from custodial settings 
  • Young people 

The Quit Kit is a package of information (booklets and brochures) which Quitline can provide to clients. There are a number of different types of quit kits: 

  • English 
  • Aboriginal 
  • Pregnancy 
  • Vietnamese 
  • Simplified and Traditional Chinese 
  • Arabic 

These are available as a digital kit which can be downloaded or as a printed collection of material.  Both options are available on our iCanQuit website.    

Health professionals can also order Quitline resources and Quit kits from iCanQuit.  

How to refer to Quitline

Online referrals are the quickest way to refer your patients to Quitline, available at www.cancer.nsw.gov.au/quitline-referral. Health professionals must ensure they have the patient’s consent for the Quitline referral, otherwise Quitline will be unable to action the referral. 

Read the full article for further information on what our Quitline Counsellors can offer, as well as access to downloadable patient resources (available in English and other languages). 

Addressing common barriers to successful referrals

  1. Referred clients do not answer the call from unknown numbers (and without consent we can’t leave a message) 
    Quitline calls come from (02) 9138 3421. Clients can save this number in their phone (using whatever name they want). You can let the client know that Quitline calls within 1-2 business days of the referral (unless otherwise requested).  
  2. Client agreed to be referred but doesn’t intend to engage.  
    Quitline Counsellors are trained to introduce clients to the service, letting people know how Quitline can help them, and help to break down preconceived ideas that someone might have about Quitline.  
  3. Client says they were not aware they had been referred. 
    It’s important to let someone know you’re referring them to Quitline; you might like to give them a brochure about Quitline to take away and read. You can order Quitline brochures from the resources order link on iCanQuit. 

 

March 2024 news and updates

New Cancer Institute Anti-Vaping Campaign launched - Every vape is a hit to your health

To address rapidly rising vaping rates in young people, the Cancer Institute NSW have launched a new anti-vaping campaign targeting 14–24 year-olds. The campaign, ‘Every vape is a hit to your health’, has been developed in consultation with young people and medical experts, and includes testimonial videos of young people who have experienced the health harms of vaping. The NSW Health Vaping Toolkit also provides further resources for young people, carers, and health professionals. 

Vaping campaign images

Vaping rates in NSW are increasing rapidly, with use highest among young people. In 2021-22 16.5% of young people aged 16-24 years were current vapers, an increase from 1.8% in 2017-18. 

Vaping is harmful to health. E-cigarettes contain harmful chemicals and toxins such as formaldehyde and heavy metals. The majority of e-cigarettes contain nicotine, a highly addictive substance.  

Cancer Institute NSW is delivering a new campaign, ‘Every vape is a hit to your health’, to young people aged 14-24 in NSW. The campaign highlights the health harms and harmful ingredients in e-cigarettes (vapes).  The campaign has been developed in consultation with young people and medical experts, and includes testimonial videos of young people who have experienced the health harms of vaping. 

The campaign is live from 28 January to 30 June 2024. It is being delivered across a range of mass media channels, including social media, online video, native, search, audio, digital display, cinema and outdoor advertising.  

The campaign key messages are:  

  • Vaping can cause lung damage. 
  • Vaping can leave you breathless. 
  • The nicotine in vapes makes them highly addictive like cigarettes. 
  • Vapes can explode and cause severe burns, usually around the face, hands, thighs and genitals. 
  • Vapes can cause nicotine poisoning. Symptoms include vomiting, nausea and diarrhoea. 
  • Vapes contain hundreds of toxic chemicals, including those that can cause cancer, heart disease and lung damage. 

The campaign connects young people to more information about vaping and quit support including digital apps, Quitline telephone support, talking to their GP and behavioural quit strategies. 

Head to our campaign webpage for more information.  

The NSW Health Vaping Toolkit also offers resources about vaping for parents and carers, teachers and schools, health professionals and young people. 

 

January 2024 news and updates

Landed: NSW Skin Cancer Prevention Strategy 2023-2030 

The third NSW Skin Cancer Prevention Strategy 2023-2030 has been released. Building on many of the achievements of the previous strategies, this Skin Cancer Prevention Strategy highlights new areas of focus including exploring healthcare settings and the opportunities to improve and influence early detection of skin cancer across all communities, including primary care. 

Cover of NSW Skin Cancer Prevention Strategy

The third NSW Skin Cancer Prevention Strategy 2023-2030 has recently been released. 

Skin cancer remains a major health issue in NSW. Two in three Australians will be treated for skin cancer in their lifetime and more than 95% of skin cancers are developed by overexposure to UV radiation. The good news is that skin cancer can be prevented and, when detected early, can have positive treatment outcomes.  

The new Skin Strategy focuses on preventing skin cancer in NSW where people work, live and play, by centring the efforts on: 

  • Goal 1: Embedding skin cancer prevention across the public sector, private sector and community. 
  • Goal 2: Improving access to quality shade at work, school, play and in public places as part of a healthier built environment. 
  • Goal 3: Increasing the adoption of sun/UV protection behaviours among those with low sun protection behaviours, those at high risk of skin cancer, and the broader community. 

The Strategy will target children, adolescents, young adults, men 40 years and over, and outdoor workers across the following priority settings: 

  • Healthcare 
  • Community 
  • Sport 
  • Education 
  • Workplaces 
  • Recreation 

There are new areas of focus to be explored over the term of this Strategy, and this includes understanding more about: 

  • groups identified in emerging research with a higher risk of skin cancer or lower adoption of sun protection behaviours 
  • awareness of the risks and impact of skin cancer among Aboriginal communities and opportunities to improve outcomes 
  • awareness of the risks and impact of skin cancer among rural and remote NSW communities and opportunities to improve outcomes 
  • the opportunities to improve and influence early detection of skin cancer across all communities, including primary care. 

The new Strategy was developed by the Cancer Institute NSW in collaboration with organisations and subject matter experts across health, education, industry, sport and recreation and the public.  

Visit our website to read the NSW Skin Cancer Prevention Strategy 2023-2030. 

 

2023 program news and updates

2023 program news and updates

New online toolkit available - Helping Mob Live Healthy and Prevent Cancer toolkit for health professionals 

Image: Helping Mob Live Healthy and Prevent Cancer Toolkit landing page

Aboriginal people in NSW experience a higher burden of cancer than other groups. The Cancer Institute NSW is committed to improving cancer outcomes and supporting culturally safe, tailored cancer care for the Aboriginal community. 

This month, the Institute is proud to launch a new online toolkit, Helping Mob Live Healthy and Prevent Cancer. This is ‘one-stop shop’ hub of information for health professionals caring for Aboriginal clients – including GPs and other staff in the primary care sector. 

The Helping Mob Live Healthy and Prevent Cancer toolkit features: 

  • cancer screening information – breast, cervical and bowel cancer screening  
  • cancer prevention tips about healthy living and wellness for Aboriginal people 
  • downloadable resources for Aboriginal people, which can be used to support yarns with your clients about the benefits of taking part in cancer screening and healthy living. 

All resources have been developed in consultation with Aboriginal health organisations and community members. Resources are designed to appeal to Aboriginal people, and take a strengths-based, culturally tailored approach.    

The goal of the Helping Mob Live Healthy and Prevent Cancer toolkit is to educate and empower Aboriginal people to reduce their cancer risk – and ultimately contribute towards reducing cancer rates and increasing positive health outcomes for Aboriginal people in NSW.  

We encourage you to visit the toolkit, share and circulate it to your networks, and like and share our social media posts and promotional materials. 

Multicultural Health Week - 2023 Encourage your patients to celebrate their culture through movement  

Image: A teenage boy and younger boy play soccer in the yard

Multicultural Health Week (MHW) is celebrated across NSW in the first week of September each year to raise awareness of health issues experienced by Culturally and Linguistically Diverse (CALD) communities and ways of addressing these issues.  

The theme this year is promoting physical activity with the tagline of “Celebrate culture through movement - Every move counts”.

Physical inactivity is one of the four biggest causes of Australia’s cancer burden so being more active reduces cancer risk.  Even small activities during the day, like taking the stairs instead of the elevator and walking to the shops can improve health and wellbeing for your patients. Based on the patient’s goals, a healthcare professional can recommend or provide the patient with a social referral to join a local community group or access a local community service or support. 

Ideas for your patients to celebrate culture through movement include learning traditional dances or sports, family activity and picnic days at the park or joining a social team of a popular sport like football, cricket or tennis. These activities promote physical fitness, cultural connection, and social interaction.  

Multicultural Health Week (MHW) is funded by the Health and Social Policy Branch NSW Ministry of Health and coordinated by the NSW Multicultural Health Communication Service (MHCS). MHCS invites you to take part in the celebrations of MH Week 2023 on Monday 4 September 2023 at the NSW Parliament House. 

MHCS is partnering with Centre for Population Health, NSW Ministry of Health and Cancer Institute NSW (CINSW) to lead the work around the theme.  

For more information, please visit MHW 2023. 

Receive continuous professional development points from the quality improvement toolkit 

A laptop screen showing the homepage of the Primary Care Cancer Control Quality Improvement Toolkit

The Primary Care Cancer Control Quality Improvement Toolkit is an easy-to-follow roadmap for improving cancer screening and prevention activities in your practice or health service.  

Each module provides guidance for steps required to promote patient-centred care and guide a team-based approach to quality improvement, utilising data and systems to increase participation in national cancer screening programs and preventive programs to reduce cancer risk.  

On completion, five continuous professional development hours of self-directed learning can be claimed by documenting your learning and activities. See an example template from AHPRA here (under Appendix 1).   

 Access the module >

Vaping reforms a breath of fresh air   

A woman speaks with her doctor about smoking cessation

NSW Health welcomes the reforms recently announced by Federal Minister for Health and Aged Care Mark Butler, and it supports taking strong action to protect the community from the harms of vaping while strengthening tobacco control initiatives. 

The proposed reforms include stronger regulation and enforcement of all e-cigarettes, including new controls on their importation, contents and packaging.

A four-year budget package commits funding for smoking and vaping cessation activities and public health campaigns, along with a capacity-building focus on Aboriginal Community Controlled Health Services to support culturally safe cancer care.  

The Tackling Indigenous Smoking Program will be expanded to include a focus on reducing vaping among First Nations people, while maintaining efforts to reduce tobacco smoking.   

The Minister also announced that a National Lung Cancer Screening Program will be established, offering imaging to eligible people, with the potential to save thousands of lives through early detection and treatment.   

Cigarette smoking causes most lung cancers. It is also a risk factor for many cancers including head and neck cancers, pancreatic cancer, oesophageal cancer and breast cancer (in post-menopausal women). 

Recording smoking status is a Practice Incentive Program Quality Improvement (PIPQI) measure and an accreditation requirement. The Cancer Institute NSW has a Smoking Cessation Quality Improvement (QI) module in the Primary Care Cancer Control Quality Improvement Toolkit.  The Smoking Cessation QI module will assist you to increase the percentage of your patient population who have a smoking status recorded. More conversations about smoking status will result in more brief interventions delivered, more withdrawal pharmacotherapy prescribed, and a greater number of patients referred to the Quitline. Vaping will be added in the near future. 

View the Smoking Cessation QI module >

 

New alcohol and cancer risk quality improvement module 

The Primary Care Cancer Control Quality Improvement toolkit is a consolidated resource developed for the primary health care sector to support cancer focused quality improvement activities.  

A group of men at a family get together drinking non-alcoholic drinks

The newly launched Alcohol and Cancer risk Quality Improvement module aims to increase the percentage of patients in each practice with an alcohol consumption status recording.

Guidance is provided to encourage conversations on alcohol, undertake Audit-C alcohol assessments, brief interventions/motivational interviewing, and increased access to treatment where indicated. 

Why is an Alcohol and Cancer Risk QI module important? 

  • There is no safe level of alcohol consumption when it comes to cancer risk.  
  • Each patient’s health record should have a current health summary that includes health risk factors such as alcohol consumption. 
  • Obtaining an alcohol consumption status on 75% of active patients is recommended for practice accreditation based on the RACGP Standards for general practices.
    • To be eligible for the Practice Incentive Program QI payments, practices must be accredited against these standards. 

Review of the Alcohol Reduction module was completed by the clinical leadership team at Centre of Alcohol and Other Drugs as well as two key general practitioners (GPs). One GP was from Illawarra Aboriginal Medical Service and is a member of the Cancer Institute NSW Primary Health Care Cancer Advisory Group. The other GP has a special interest in addiction medicine. 

View the new module >

Say no to the tobacco industry on World No Tobacco Day  

 

A GP speaking with his patient about smoking cessation

On 31 May each year, the World Health Organization and the public health sector recognise World No Tobacco Day. The theme for 2023 raises awareness about the impact of the tobacco industry on agriculture, and encourages farmers to turn to sustainable, nutritious crops instead of growing tobacco.  

Fortunately, there are no valid licenses for commercial or personal farming of tobacco in Australia, however, the theme highlights the broad reach of the tobacco industry.  

The industry remains under the spotlight as they expand into the e-cigarette market, as the emergence of vaping threatens to undermine the progress and investment in tobacco control over recent decades. Vaping, or e-cigarette use, continues to rise in NSW, particularly among young people.  

While there may be a role for vaping as a smoking cessation aid, systematic reviews outline evidence of the harms of vaping, particularly among people who do not smoke. Evidence also supports a gateway effect, that people who vape are three times more likely to take up smoking. Get more facts about vaping, including information for health professionals: www.health.nsw.gov.au/vaping  

This emerging public health issue needs the support of the primary care sector, who are well placed to identify people who smoke and vape and offer advice and support to quit. Embedding the Ask, Advise, Help (AAH) model into routine practice is recommended in the RACGP’s guideline Supporting smoking cessation: A guide for health professionals.  

 

 New skin cancer prevention campaign targets outdoor workers 

 

A farmer in sun protection sitting on the back of his ute enjoying a cuppa

The Cancer Institute NSW has launched a new campaign to encourage outdoor workers in NSW to take sun protection seriously and change their routine before skin cancer changes it for them. 

Outdoor workers are exposed to over three times more ultraviolet radiation than indoor workers, putting them at higher risk of skin cancer that can’t simply be cut out. 

The campaign depicts the seriousness of skin cancer along with supportive materials to enable outdoor workers to adopt the sun safe behaviours in the context of their workplace.  

To view the stakeholder kit and download assets please visit the campaign webpage. 

Increasing physical activity to reduce cancer risk: New factsheet and worksheet

 

An elderly man stretches in a park before going for his run.

Physical activity can reduce the risk of cancer, improve the outcomes during cancer treatment and improve recovery during survivorship. 

Exercising regularly helps protect against weight gain, overweight and obesity, known risk factors for cancer and reduces the risk for several cancers, including lung, breast and liver

Key resources for your patients:

Please share these easy to use, downloadable resources with your networks.

More information about physical activity and cancer is available on our website.

2022 program news and updates

2022 program news and updates

Cancer Institute NSW launches new skin cancer campaign – ‘Arrows’

 

The Cancer Institute NSW has launched a new campaign to encourage younger people, aged 18-24 years in NSW, to protect their skin from UV radiation. 

This group is particularly at risk as they are less likely to protect their skin from the sun than the general population.


The campaign demonstrates the scale and danger of UV rays by depicting them as illuminated ‘Arrows’ hurtling down from above, transforming it into a tangible and ever-present threat.  

Downloadable posters to display in your health service along with other campaign assets can be found here: https://www.cancer.nsw.gov.au/Arrows-Campaign-Toolkit

For more information about the campaign, please contact cinsw-skincancerprevention@health.nsw.gov.au.

Alcohol and breast cancer – the challenges

 

A female GP speaks with a female patient

1 in 7 women in NSW will be diagnosed with breast cancer in their lifetime.

In a recent article on Insight MJA, the link between alcohol, breast cancer and women’s perceptions was discussed. 

The research found that “women do not necessarily see their drinking as a problem to be fixed. Even if they are aware of the

message that alcohol causes breast cancer, they may accept the risk because of the important role alcohol plays in their lives, not something they want to (or feel that they can) give up or even reduce”.

View the study >

The article shares some key points:

  • A recent study showing that women want more information on alcohol and breast cancer risk.
  • GPs and health professionals have a critical role in addressing modifiable risk factors, and are often the only place women seek preventive health advice.
  • Messages on alcohol and breast cancer risk need to be thoughtfully tailored for the audience 

A greater awareness of the risks of alcohol and cancer is needed. In NSW the percentage of women drinking weekly increased from 29.7% in 2010 to 34.8% in 2020.[1]

There is no safe level of consumption when it comes to alcohol intake and cancer risk as alcohol is a group 1 carcinogen. There is now strong evidence that alcohol consumption is linked to several cancers, including cancers of the mouth, pharynx, larynx, oesophagus, breast, stomach, liver, and bowel. The less you drink, the lower your risk of harm from alcohol.  

Ask your patients about their alcohol use. The below tools will help your patients keep track of how much alcohol they are drinking.

Sources:
1. https://www.health.nsw.gov.au/aod/resources/Publications/alcohol-surveillance-report-2021.pdf
2. Current NHMRC guidelines recommend: • Healthy men and women should drink no more than 10 standard drinks a week and no more than 4 standard drinks on any one day. • Children and people under 18 years of age should not drink alcohol. • Women who are pregnant, breastfeeding or planning a pregnancy should not drink alcohol.

Skin cancer prevention campaign launching in November

 

Two young men running in the park wearing sun protection

 

Cancer Institute NSW is delivering a new skin cancer prevention campaign mid-November to motivate young people in NSW to protect their skin from harmful UV radiation.  

Melanoma is the most common cancer among young Australians, who are particularly at risk due to their high exposure to UV radiation and low use of sun protection behaviours compared to other age groups.

The new campaign will use a combination of hard-hitting and supportive creative assets over the summer period and is being delivered across social media, YouTube, digital display, cinema, music apps and outdoor advertising.  

A campaign kit including a list of downloadable and social media assets will be distributed to stakeholders across NSW mid-November. Stakeholders, including those working in Primary Care, are encouraged to share campaign assets across their communication networks.  

For more information:

To be included on the campaign kit mailing list, or for more information about the campaign itself, please contact Heather Tupper at CINSW-skincancerprevention@health.nsw.gov.au. 

'Shisha No Thanks' online training module 

Shisha No Thanks Logo

Shisha (also known as waterpipe, argileh or hookah) is a form of tobacco smoking that increases the risk of lung, head and neck cancers, as well as a range of other health harms. 

As a primary care provider, you may have patients or clients, particularly from Arabic speaking or other culturally and linguistically diverse (CALD) backgrounds, who smoke shisha.  

Primary care providers are well placed to support patients to reduce unhealthy behaviours, including shisha smoking.  

You can access this 20-minute interactive online training module to learn more about the following: 

  • The health risks associated with shisha. 
  • Having conversations with patients about shisha smoking. 
  • Where to refer patients for further support. 

Access the training module >

Educating your patients on the link between drinking alcohol and reducing their cancer risk

A group of men drinking giving cheers with their water and orange juice glasses

When it comes to cancer, there is no safe level of alcohol consumption. 

Alcohol is a group one carcinogen and is linked to eight different types of cancers.1 Over 3,200 cancer cases could be prevented each year if people limited their alcohol consumption,2 and one in three cancers can be prevented through healthy lifestyle choices.3 

The 2020 Australian guidelines to reduce health risks from drinking alcohol states that healthy adults should drink no more than 10 standard drinks in a week and no more than 4 standard drinks on any one day to reduce the risk of alcohol related harm.  

Not drinking alcohol is safest for people who are pregnant, planning a pregnancy or breastfeeding and for young people under 18 years. 

Speaking with your patients about their alcohol consumption and tailoring the health information to them can have many co-benefits, including better mental health and overall wellbeing outcomes. Read our previous article, to find out more about alcohol and setting patient goals. 

Along with reducing alcohol intake, maintaining a healthy weight, healthy eating, being active, practising the 5 sun-safe behaviours and quitting smoking are all key ways patients can reduce their cancer risk.  

For more information to enable discussions with patients about reducing their alcohol consumption, please visit our website. 

For more information:

Contact Irina Kamychnikova, Project Officer Skin Cancer Prevention and Healthy Lifestyles, irina.kamychnikova@health.nsw.gov.au

Sources:
1. International Agency for Research on Cancer. Personal Habits and Indoor Combustions. Volume 100E. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Lyon: IARC, 2012. 
2. Cancers in Australia in 2010 attributable to the consumption of alcohol," Aust N Z J Public Health 2015. Available from http://www.ncbi.nlm.nih.gov/pubmed/26437723 
3. Whiteman DC, Webb PM, Green AC, Neale RE, Fritschi L, Bain CJ, et al. Cancers in Australia in 2010 attributable to modifiable factors: summary and conclusions. Aust N Z J Public Health. 2015;39(5): 477–to84 

Monitor the UV index and protect your skin this spring. 

 

The UV Index

Spring is here and summer is around the corner. As the weather warms, the ultraviolet (UV) index is also increasing. 

Unlike the sun or temperature, UV radiation cannot be seen or felt but is present even on cool and cloudy days and can cause sun burn, skin damage and lead to skin cancer. 

The UV index is a scale ranging from 1 (low) to 11+ (extreme) and changes throughout the day.  In NSW, the UV index is 3 and above, for more than 10 months of year, generally from August to May. 

When the UV index is 3 or above, it’s important for all of us to remember the 5 sun protection behaviours: 

  1. Slip on protective clothing that covers arms, legs and shoulders 
  2. Slop on 30 to 50+ SPF broad-spectrum water-resistant sunscreen 20 minutes before going outside and reapply every 2 hours 
  3. Slap on a wide brim hat that protects the face, ears and neck
  4. Seek shade throughout the day 
  5. Slide on sunglasses that meet Australian Standard (AS 1067). 

Advice for practitioners: 

  • Remind your patients to protect their skin – especially those with skin types 1-4.  
  • Encourage patients to check the UV index before going outside. A personalised daily UV alert can be sent directly to your phone, download Cancer Council’s free SunSmart app. 
  • Encourage patients to become familiar with the look of their skin and flag any changes they notice. Any new lesion or lesion that changes its shape, colour or size is worth discussing with a medical professional. Early identification and treatment of skin cancer improves health outcomes. 

Cancer Institute NSW will be launching a new skin cancer prevention campaign for young people aged 18-24 years in November. Communication resources for primary care providers will be available around this time.

Visit our website to find out more about the UV Index and preventing skin cancer. 

For more information contact: 

Irina Kamychnikova, Project Officer Skin Cancer Prevention and Healthy Lifestyles CINSW-SkinCancerPrevention@health.nsw.gov.au.  

Dry July might be the goal your patient needs?

 

alcohol causes up to 8 types of cancer

 

 

 

 

 

 

 


Drinking alcohol is widespread in Australia. Nearly 80% of Australians aged 18 years and over report consuming alcohol in the past 12 months.

It is recognised that ethanol (the chemical compound present in all alcoholic drinks) is a Group 1 carcinogen. Any amount of alcohol consumed, regardless of type, increases the risk of developing an alcohol-related cancer; the higher the consumption, the higher the risk over a lifetime.


The less a person drinks, the lower the risk of harm from alcohol.
There is now strong evidence that alcohol consumption is linked to eight different cancers.
See more information here.

National Health & Medical Research Council guidelines suggest:

To reduce the risk of harm from alcohol-related disease or injury, healthy men and women should drink no more than 10 standard drinks a week and no more than 4 standard drinks on any one day. Women who are pregnant or breastfeeding should not drink. Nor should those under 18 years. 

Cancer Institute NSW recommends ensuring alcohol consumption questions are part of your health assessments. You can identify patients with risky levels of alcohol consumption, by asking three simple questions from the Audit C:  How often are you drinking? How many standard drinks containing alcohol do you have on a typical day? How often do you have six or more drinks on one occasion? 

We also provide content for your patient here: https://www.cancer.nsw.gov.au/prevention-and-screening/preventing-cancer/reduce-your-cancer-risk/drink-less-alcohol

Assisting your patient to set a goal such as participating in Dry July during a brief intervention, could be a great motivator for many people. There are health benefits for those abstaining from alcohol and funds raised for people affected by cancer.  

For practioners:

  • Alcohol consumption status is one of the one of the ten PIPQI measures
  • Meeting accreditation requirements such as, patients having a current health summary, with lifestyle risk factors recorded along with tailored health information. See more information.
  • Provide patient support for alcohol assessment/management through the below available MBS items:
  1. general consultations
  2. chronic disease management plans and team care arrangements
  3. Mental health treatment plans
  4. Aboriginal health assessments
  5. case conferences
  6. home/institution visits

For more information, contact: 
Kathryn Duggan, Primary Care Strategic Advisor, Cancer Institute NSW: cinsw-primarycare@health.nsw.gov.au

World No Tobacco Day 2022 provides one more reason to quit

 

Family seeking shade


The World Health Organization (WHO) has announced the theme of ‘Tobacco: Threat to our Environment’ for World No Tobacco Day 2022, to raise awareness about the environmental impact of tobacco, and provide another reason to consider quitting smoking. 

Tobacco farming, and the manufacture, distribution and use of tobacco products have severe environmental consequences, including deforestation, use of fossil fuels, and dumping or leaking of waste products.


With about 90% of tobacco production concentrated in the developing world, much of the environmental burden falls on countries with the least resources to cope with them. 

We will be sharing messages about the environmental impact of tobacco being another reason to consider quitting on social media in support of World No Tobacco Day 2022. Like, share or post your own content using the hashtags #BreatheOnCountry and #WNTD2022.

Image: Tobacco leaves, Cuba, by Tim Stief, Unsplash

Risk of addiction with e-cigarette use

 

Vaping campaign

Use of e-cigarettes (known as vaping) has increased in recent years, with uptake highest among young people. A new systematic review of international evidence, led by Professor Emily Banks at the Australian National University, confirms that vaping can be harmful to health, particularly among people who don’t smoke and young people. 

While many major health outcomes associated with vaping are not yet known, the report identified risks including addiction, poisoning, acute nicotine toxicity, burns and injuries, lung injury, environmental waste and indoor air pollution.


Less direct evidence indicates adverse effects on cardiovascular health markers including blood pressure and heart rate, lung function and adolescent brain development and function.

A key finding of the review and of most concern to the gains Australia has made in tobacco control over recent decades, is evidence supporting a ‘gateway effect’ – that non-smokers who use e-cigarettes are three times as likely to smoke tobacco cigarettes as people who do not use e-cigarettes.  

The systematic review and a summary brief are available here: nceph.anu.edu.au/research/projects/health-impacts-electronic-cigarettes 

NSW Health ‘Do you know what you’re vaping?’ campaign and toolkit 

A new targeted social media campaign is underway to highlight to young people that vapes can contain the same harmful chemicals found cleaning products, nail polish remover, weed killer and bug spray. 

Health professionals are urged to talk to parents, carers and young people about the hidden impacts of vaping. NSW Health has created a Vaping resource toolkit to address common misconceptions about vaping and to provide information and strategies to educate and protect young people from the harms of vaping. The toolkit contains factsheets, posters and other assets to support conversations.

Get the facts at www.health.nsw.gov.au/vaping.

For more information, contact: 
Phillipa Hastings A/Tobacco Control Portfolio Manager phillipa.hastings@health.nsw.gov.au

World Health Day 2022: Creating healthy built environments

Thursday 7 April marks World Health Day 2022. This year the World Health Organization is focusing global attention on actions to keep humans and the planet healthy by advocating for the creation of sustainable societies focused on wellbeing. In line with this theme, new research has found that integrating skin cancer prevention with healthy built environments is key to reducing solar ultraviolet radiation (UVR) exposure2.

Family seeking shade

UVR causes over 95% of all skin cancers, Australia’s most common and costly cancer. Primary health care has significantly contributed to improving awareness of solar UVR, skin cancer and the need for sun protection in different settings across Australia. Skin cancer medicine is a core component of Australian general practice and is consistently in the top 10 conditions managed. 

Evidence suggests UVR exposure can be reduced by 75% through well designed and correctly positioned quality shade, which includes a combination of built and natural sources.


Shade availability and accessibility are key to shade use. In addition to its benefits to reducing UVR exposure, shade also facilitates healthy behaviours such as physical activity and connecting with others outdoors.

Existing evidence highlights that skin cancer is highly preventable through five (5) key individual behaviours that aim to reduce UVR exposure. General practitioners should advise patients to:

Skin-Shirt-CINSW


1. Slip on protective clothing that covers arms, legs and shoulders

Skin-Sunscreen-CINSW


2. Slop on 30 to 50+ broad-spectrum water-resistant sunscreen 20 minutes before going outside and reapply every 2 hours

Skin-Hat-CINSW


3. Slap on a wide brim hat that protects the face, ears and neck

Skin-Shade-tree-CINSW


4. Seek shade throughout the day

Skin-Sunglasses-blue-CINSW


5. Slide on sunglasses that meet Australian Standard (AS 1067).


The benefits of shade to skin cancer primary prevention is outlined in our latest research about integrating shade provision into the healthy built environment. The article was recently published in a special edition of Public Health Research and Practice by the Sax Institute. This edition also includes a journal article on the analysis and early detection of skin cancers, outlining current approaches as well as emerging technologies and devices relevant to primary care.

To learn more about Melanoma incidence, prevalence, treatment patterns and education modules read our Melanoma article from our December 2021 update. 

For more information about this article please contact: Irina Kamychnikova, Irina.Kamychnikova@health.nsw.gov.au

References:
1.  Arnold M, de Vries E, Whiteman DC, Jemal A, Bray F, Parkin DM, Soerjomataram I. Global burden of cutaneous melanoma attributable to ultraviolet radiation in 2012. Int J Cancer. 2018;143(6):1305–to14.
2.  King EL, Thompson S, Groskops N. Integrating shade into the healthy built environment agenda: the approach taken in NSW, Australia. Public Health Res Pract. 2022;31(1):e3212206. https://doi.org/10.17061/phrp3212206
3.  Parsons PG, Neale R, Wolski P, Green A. The shady side of solar protection. Med J Aust. 1998;168(7):327–30.

Vaping: Prescribing and young people

Female GP with Vietnamese young woman


Use of e-cigarettes (commonly called vaping) is increasing in NSW, with young people the highest users. 

In 2019-2020, 21.4% of young people (aged 16-24 years) had ever vaped, compared to 9.6% of the NSW population. And 4.5% of this younger age group were current users, compared to only 2% of the wider NSW population. Evidence shows that young people who vape are three times more likely to take up tobacco smoking than those who don’t vape.


Information for primary care providers

The Royal Australian College of General Practitioners is hosting a webinar on e-cigarettes presented by Dr Lyndon Bauer and Dr Bronwyn Milne on 29 March 2022. This webinar will explore the evolving landscape of e-cigarettes and focus on use by young people as well as providing practical tips on vaping and smoking cessation, including referral pathways.

View more information and register HERE.

Prescribing nicotine vaping products

Following changes by the Therapeutic Goods Administration, from 1 October 2021, consumers require a prescription to legally purchase nicotine vaping products. This regulatory change was implemented to balance the need to prevent young people from taking up vaping, while enabling people who smoke to access nicotine vaping products to support smoking cessation. 

The RACGP updated its Supporting smoking cessation: a guide for health professionals, noting that:  

  • nicotine vaping products are not a first line treatment for smoking cessation
  • first-line smoking cessation support includes TGA-approved pharmacotherapies and behavioural support, such as that offered by Quitline
  • nicotine vaping products may be considered, along with behavioural support, for people who have tried first line treatments for smoking cessation and failed, and remain motivated to quit smoking 
  • nicotine vaping products should not be prescribed to young people.

It should be noted that the Therapeutic Goods Administration has not yet approved anynicotine vaping products. There are few high-quality trials comparing nicotine vaping products with existing TGA-approved pharmacotherapies to help support people to quit. 

Information is available to prescribers on the TGA website

Primary care updates Screening updates

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Prevention and early detection