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Epidemiology is the study of the spread and causes of health-related events such as disease, and the application of this study to the control the disease. It is a tool that public health authorities use to determine the cause of a disease and affected populations. Epidemiology can also assist in developing strategies to improve public health and evaluate the effectiveness of strategies in place to treat the disease. It is practiced through studies in which analysis data is performed allowing for the identification of pattern and trends in the incidence, prevalence and mortality rate of the disease. This information can is used to identify areas and ways in which the overall health of the population can be improved. An instance of this of this is seen in the epidemiology study of Skin Cancer in Nambour, Queensland or epidemiology study in the Sun Smart program.
The epidemiology study of skin cancer tested the hypothesis that the incidence of skin cancers specifically Basal cell carcinoma and Squamous cell carcinoma (skin cancers) in outdoor workers is greater than that in indoor workers. This study was carried out between 1986 and 1992 with a random sample of 3,000 individuals aged 20-69 years listed on the electoral roll as residents of Nambour, Queensland, and invited to participate in a skin cancer survey. The survey was conducted by experienced dermatologists examining all participants for prevalent skin cancers on the head, neck, and upper limbs, as baseline for the study and prevalence rate of BCC and SCC. During clinical examination the survey also recorded the number and location of skin cancers, hair colour, number of raised and flat nevi on the hands and arms, and signs of solar skin. Each participant was asked about present and past occupations (whether outdoors, indoors, or a mixture of indoors and outdoors), typical outdoor recreational exposure, usual number of hours spent outdoors, number of painful sunburns experienced in their lifetime, sun safety routine, general lifestyle and parents' countries of origin. Information about skin cancers treated between December 1987 and August 1992 was obtained through an additional postal survey. Incident skin cancers that were diagnosed clinically at the 1992 survey were biopsied for the diagnosis by a single pathologist, who had also examined all biopsies of suspected skin cancers diagnosed in the 1986 survey. Incidence rates of BBC and SCC were adjusted by age, degree of solar skin damage, skin colour, and sun exposure adjusted using a scientifically approved model. Age-adjusted skin cancer incidence rates were estimated to be 2,528 per 100,000 person among males and 1,676 per 100,000 among females over the 6 years of follow-up.
However, it showed there was no statistically significant correlation between outdoor occupation and the incidence of BCC and SCC skin cancer. Researchers stated that may have been the result of outdoor workers practicing sun safety when exposed to the sun. It also showed that there was a correlation of increase presents of solar keratosis (sun damage) to higher incidence rates of BCC and SCC cancer. As, subjects with no keratoses have an incidence percentage of BCC and SCC of 1.00%, followed by subjects with 1 to 10 keratoses at 1.62% and the highest incidence percentage of 2.18% with subjects of 11 or more keratoses. This information led public health authorities such as by Cancer Council Victoria and the Victorian Health Promotion Foundation to create and continue funding campaign such as the SunSmart program. The SunSmart program mission is to reduce skin cancer incidence, morbidity and mortality through a targeted prevention, with the message of “Slip! Slop! Slap! Seek! Slide!”. Epidemiology studies like “SunSmart Evaluation Study of 1992” have also monitor are the SunSmart program, leading to the conclusion that while skin cancer incidence in Victoria continues to rise, there are now falling incidence rates in men and women younger than 40 years, consistent with a positive effect of the SunSmart program on behaviour change. SunSmart Evaluation Study have found that target audiences needed to be widened to from young children to adolescents. Thus, hard-hitting messages and graphic prompts were incorporated into the media campaign, designed to shock people into action to target older audiences.
In conclusion, epidemiology is paramount instrument, that provides useful information that can be used to identify the cause of a disease and design strategies to cope with diseases within the population. For example, the epidemiology study of Skin Cancer in Nambour, which identified that sun damage can lead to skin cancer. It is also used by public health authorities to evaluate and improve strategies that are already in place. This is seen in the SunSmart Evaluation Study of 1992, where the SunSmart program was monitored, and issues such as target audience were identified and improved.
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