ABSTRACT
Ultraviolet radiation is the most important carcinogenic agent related to the development of melanoma and nonmelanoma skin cancer, and primary prevention efforts focus on reducing exposure to sunlight and ultraviolet sunlamps. Favorable societal views of suntanning serve as an obstacle to skin cancer prevention. Although the education of patients and the public regarding the risks of excessive ultraviolet light exposure is an important goal in medicine today, few physicians have more than a vague knowledge of how current attitudes actually developed during the past century. Opinions about ultraviolet light exposure were not static, but evolved with increasing scientific knowledge and changing social mores. A critical interplay occurred between the prevailing medical and nonmedical views on the subject. In this article, we focus on the century's start (1900-1920)--a time when vigilance against significant sun exposure, a relic of the 19th century, was eroding, and the roots of later attitudes toward sunbathing were already manifest. Medically, the view of sunlight as salutary was bolstered by the success of phototherapy, which was introduced in the 1890s. The first clinical observations associating long-term sunlight exposure with skin cancer were also reported during this time. The association, however, was poorly understood, and this work was largely ignored by the medical profession and remained essentially unknown to the public.
Subject(s)
Heliotherapy/history , Skin Neoplasms/history , Attitude to Health , Female , Heliotherapy/adverse effects , History, 20th Century , Humans , Male , Skin Neoplasms/etiology , Skin Neoplasms/prevention & control , Sunburn/history , Sunburn/prevention & control , Ultraviolet Rays/adverse effects , United StatesABSTRACT
BACKGROUND: The development of knowledge concerning the role of sun exposure in causing skin cancer has been a gradual one. OBJECTIVE: This article reviews the article by Urbach who used manikin coated with an ultraviolet dosimeter to see exactly where on the head and neck the exposure was greatest. CONCLUSION: Urbach showed that the areas of greatest sun exposure on his manikins corresponded with the location of 95% of squamous cell carcinoma and 66% of basal cell carcinoma. He also clearly showed the importance of scattered sky and reflected radiation.
