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OPINION

CANCER

‘Avoiding the sun is as dangerous as smoking’

Staying out of the sun to avoid skin cancer? Don't, argue Swedish doctors Pelle Lindqvist and Håkan Olsson.

'Avoiding the sun is as dangerous as smoking'
How many sun hours do we get in Sweden anyway? Photo: Janerik Henriksson/TT

For 40 years we have been taught to avoid the sun in order to reduce the risk of malignant melanoma skin cancer. But new findings show that avoiding exposure to the sun, on the contrary poses a major health risk.

We believe that those who campaign for “the less sun, the better” take large responsible for our health. Those who follow this advice seem to shorten their life expectancy by half-a-year to two years.

There have been three great lifestyle factors that are strongly related to illness and death: smoking, inactivity and obesity.

Our research indicates that people who are both non-smokers and non-sunbathers have the same risk of death as those that are both smokers and sunbathers. Avoiding the sun thus puts you at as great a risk of dying as smoking does.

We also find that women who avoid the sun double their risk of cardiovascular diseases such as heart attacks, strokes and blood clots. Twice as many who don't sunbathe also contract “other” illnesses, such as diabetes, multiple sclerosis and lung disease.

In all likelihood, people who live in the Nordic countries have become pale because it gives them an advantage. In terms of nature, it is the “survival of the fittest”.

If you listen to the debate, you are led to believe that it is dangerous to be pale or sensitive to the sun. Redheads are, however, probably the ones best suited to a sun-starved life in Scandinavia.

Sun-sensitive and fairskinned people likely need less sun for their health, and should be outside in the sun a shorter amount of time before they cover themselves up. Sunscreen “protection” is not a good idea.

It is likely that sunscreen eliminates the skin's reaction to too much sun, but does not significantly protect against melanoma. The price for sun-sensitive people's adaption to a sun-starved environment is that the risk of melanoma increases at over-exposure to the sun.

There is no scientific study that shows that you can be outside in the sun longer with sunscreen, in terms of the risk of melanoma. In Sweden, we see that sunscreen users double their risk of melanoma, most likely because they have spent too much time in the sun.

We share the same concern as the Swedish Radiation Safety Authority (Strålskyddsmyndigheten) that 80 percent of Swedes feel safe in the sun after applying sun lotion. Changing this way of thinking is key when it comes to decreasing the rate of malignant melanoma.

One thing many guidelines for sunbathing have had in common is that they have been poorly founded in science. Some campaigns have, on the contrary, helped create wrong and unhealthy sunbathing habits.

In 1992 a campaign was run in Sweden called “how to sunbathe safely”. It advised that you should “use sunscreen with a high sun protection factor (SPF) at first (…) then slowly increase the number of hours in the sun from one hour a day to five, six”.

This sort of advice likely contributes to both the wrong way of thinking and a large increase of melanoma in Sweden. You should/cannot stay out in the sun for longer time with sunscreen. After you have received a “lagom” dose of sunshine (preferably without sunscreen) you should seek the shade or get dressed.

So what can we do to get the sun we need without increasing the risk of melanoma?

The melanoma risk increases when you over-tan (for example spend too much time in the sun with sunscreen), get burned (get blisters and so on) and during exaggerated use of sunbeds. At the same time we know that those who work outside do not increase their risk of melanoma. Daily exposure to the sun thus does not increase the risk of melanoma.

Our advice is that famous Swedish word 'lagom' [meaning average or just right]. Sunbathe 'lagom' every day.

A 'lagom' start is having your lunch coffee in the sun. Then it will be every day, in the middle of the day when you enjoy the best rays – and not too long.

This article was written by doctors Pelle Lindqvist, who works at the women's hospital in Huddinge, and Håkan Olsson, from the oncology department in Lund. It was first published in Swedish by SVT.

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OPINION & ANALYSIS

OPINION: How I learned that Sweden is a nation of secret queue-jumpers

Swedes have a reputation as a nation of orderly queuers. But it doesn't take long living here before you realise that for things that matter - housing, schools, health treatment - there are ways of jumping the line.

OPINION: How I learned that Sweden is a nation of secret queue-jumpers

Soon after my daughter was born, I emailed Malmö’s sought after daycare cooperatives to get on their waiting lists. 

I didn’t get an answer from any of them, so a year later, I began dropping her off at the daycare allotted to us by the municipality. 

It was housed in a concrete structure so grim-looking that it was used as the gritty backdrop to the police station in The Bridge, the Scandinavian Noir crime drama based in Malmö. Getting there involved taking a lift that frequently smelled of urine. The rooftop playground was (after we had left) used by local dealers to stash drugs.

But to be fair, it was close to our house and in other ways, perfectly adequate. 

A year later, though, I got a call from one of the cooperatives I had emailed. My daughter Eira was next in line. Did I want to come to meet the staff and existing parents?

When I arrived, I discovered I wasn’t alone. My friend, a Swede looking to establish herself in Malmö after a decade in London, was there, as were several others.

Listen to a discussion about queue-jumping on Sweden in Focus, The Local’s podcast. 

Click HERE to listen to Sweden in Focus on Apple Podcasts, Spotify or Google Podcasts.

I soon had a distinct feeling of being outmanoeuvered, as I watched her identify the parents in charge of new intakes and get to work on them, asking intelligent questions, demonstrating her engagement, and generally turning on the charm. 

A few days later I discovered that, even though I’d been told Eira was top of the list, my friend’s son had got the place. 

This was my first lesson in Swedish queuing, and it is a pattern I’ve seen time and time again.

Swedes, I’ve learned, generally respect a queue if it’s visible, physical, and not about anything particularly important. But when it comes to waiting lists for things such as housing, schools, and healthcare, many people, perhaps even most, will work their contacts, pull strings, find loopholes, if it helps them jump the line. 

When it was time for the children of the parents I knew to go to school, several of them — all otherwise upstanding law-abiding people — temporarily registered themselves at the addresses of friends who lived near the desirable municipal options, and then, after their children got places, moved back.

When I protested weakly that by doing this were depriving someone else’s child of their rightful place, they simply shrugged. 

When Eira joined Malmöflickorna, a dance gymnastics troupe that is a kind of Malmö institution, the other parents whispered to me that joining the troupe helped you get your child into Bladins, Malmö’s most exclusive free school, as the troupe had longstanding links. 

When it comes to accessing health treatment, I’ve learned, it doesn’t pay to stoically wait in line. When I was recently sent for a scan, I immediately rang up the clinic my primary health care centre had chosen for me. The receptionist spotted a time that had just become free the next day, and slotted me in, saving what could have been months of waiting. 

If you’re looking to buy a house, I’m told it pays to develop good relationships with estate agents, as sometimes they will sell a house without even listing it. And there are all sorts of ways to jump the long rental queues in Swedish cities, some involving paying money, some simply exploiting contacts. 

I’m not, myself, much of an operator, but I’ve also learned to take advantage of any opportunities that crop up. 

A year after we had lost our battle for the daycare place, the same Swedish friend got in touch. She had managed to upgrade to an even more sought-after cooperative. (This one has had world-famous novelists and Oscar-contending film directors as present and former parents.)

There was a place free, and she was in charge of the queue. Did we want it for Eira? The queue at this daycare, I soon discovered, was pure fiction. The municipality has since cracked down, but at the time, places went to the friends and contacts of whichever parents happened to be on the board, or failing that, to people in the queue who seemed the right kind of person. 

It didn’t seem right, but of course, we took the place. 

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