‘Fry now pay later’: tracing a century of skin cancer messaging in Australia

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Max Dupain via Mitchell Library, State Library of New South WalesIn 1981, a jingle played out across Australia, encouraging us to “Slip, Slop, Slap!”In 2023, the jingle was added to the National Film & Sound Archive’s Sounds of Australia registry in recognition of the way the tune – and its message – helped shape Australia.But Slip, Slop, Slap! wasn’t the start of Australian skin cancer messaging. For that, we need to travel back to the 1930s.What does going back in time tell us about our relationship to the sun? And how can history inform efforts to address the skin cancer conundrum? Understanding the sun’s dangersAlthough Indigenous Australians can suffer from skin cancers, their ancestors learned to live with the sun’s extremes, seeking shade in the hottest hours. When white woman Eliza Fraser was shipwrecked in 1836, local people treated her sunburn with sand, charcoal and grease.Medical and popular understandings of skin cancer advanced slowly. In 1895, some thought cancer was contagious. Sydney’s Liverpool council debated whether sufferers should be confined to asylums or allowed freedom of the town.In 1912, pioneering Melbourne dermatologist Herman Lawrence attributed skin cancer to constant exposure to the sun’s rays under Australia’s particular climatic conditions.Sydney practitioner Norman Paul’s The Influence of Sunlight in the Production of Cancer of the Skin (1918) and the later Cutaneous Neoplasms (1933) were internationally renowned medical textbooks, furthering the medical argument for better sun protection. Two young women and a man sunbaking on Coogee Beach, 1935. Sam Hood via Mitchell Library, State Library of New South Wales From the 1920s, suntan (sometimes called “sunburn”) switched from a marker of working-class status to a social fad. Beauty parlour sunlamps along with the cosmetics industry played an increasing role as commercial determinants of health by promoting darker skin tones.Sharing the newsSporadic anti-tanning messaging in the press became more focused in the 1930s with encouragement from annual Commonwealth Department of Health cancer conferences. New state-based anti-cancer organisations soon touted warnings to general practitioners, education departments and the general public, via pamphlets, bookmarks, fundraisers and health bulletins.In the Medical Journal of Australia in 1932, Dr E.H. Molesworth encouraged wearing hats outdoors, confirming that ultraviolet rays in sunlight were a key cause of skin cancer. This message, moreover, was being shared far beyond the medical research community.In 1930, the Queensland Cancer Trust issued an educational circular on skin cancer directed at hospitals, general practitioners, pharmacists and the broader public.“The means of preventing Sun Cancer are simple,” it advised: persons who are exposed to open sunlight should wear wide brimmed hats to protect the face, and should completely cover the rest of the skin. Similar advice was disseminated during New South Wales Health Week in 1931, and the tendency for Australians to go outside in summer without a hat – dubbed the “no-hat habit” – came under scrutiny in newspapers from Perth to Rockhampton.In the 1950s, “any change in a wart or a mole” became one of the seven danger signals of cancer, a headline feature in public health campaigns throughout Australia.Subsequent decades saw skin cancer targeted with a succession of catchy phrases from “Don’t U.V.O.D.”, “Don’t turn your back on a mole” and “Kids cook quick” to “Save your own skin” and “Fry now pay later”.But tanning continued to be a big part of Australian culture. Behavioural changes around sun protection were counteracted by longstanding messaging about sunlight and health and the postwar boom in beach culture and skimpier swimwear.Moving forwardPublic health campaigns improved skin cancer awareness but could lead to unintended outcomes. Australians turned to artificial means for their golden glow under the mistaken impression this was healthier than the sun’s rays.In the 1970s, European tanning machines were introduced to Australians. Their importation may seem like bringing coals to Newcastle, but this is a good example of the complicated cultural factors behind behavioural change that belie the simple “bronzed Aussie” stereotype.City solariums were part of the kit of a new generation of lifestyle centres that fostered clubbish exclusivity. Solarium tans became a marker of social competence and cosmopolitan aspiration, and Australians were slow to heed growing medical concern and cancer council warnings as to their harm.In 2007, Clare Oliver spoke publicly about the dangers of solariums before her death from melanoma aged 26. Such a moving public example reinforced decades of warnings and gave momentum to stricter industry regulation and the eventual ban on commercial solariums by the mid 2010s.The Commonwealth Department of Health began rating sunscreen effectiveness in the 1970s. Later studies, however, concluded that increased use could also lead sunbathers to “sunscreen abuse” by spending more rather than less time outdoors.Slip, Slop, Slap! in 1981 and SunSmart, a skin cancer prevention program launched in 1988 to encourage sunscreen and wearing hats in schools, gained traction because they drew on good science. They were also able to repeat – but more importantly to translate – old messages for new generations.The facts remain. Australia has the highest rate of skin cancer in the world. Two in three Australians will develop some form of skin cancer in their lifetime. Nearly 2,000 Australians die from skin cancer annually. Nearly one in four teens falsely believe a tan protects them against skin cancer. Skin cancer messaging, now a century old, remains vitally important. Its task is never completed and its challenges are always changing. It will work most effectively when trust in science goes hand-in-hand with historical insight.Professor Andrew J May is lead Chief Investigator on 'Cancer Culture: understanding anti-cancer campaigns in Australia', an Australian Research Council funded Linkage Project with Cancer Council Victoria. He is currently writing a history of skin cancer and sun culture in Australia.