Are We Getting Trapped in the ‘Sunscreen Paradox’?

There are surprising variations in skin cancer rates among the four provinces in Atlantic Canada, and researchers wanted to know why.


Melanoma skin cancer is a growing concern globally, and this worrisome trend is also observable in Canada. While it might seem that the straightforward solution is to be more vigilant about sun protection, recent research has raised doubts about the effectiveness of traditional sun protection measures like sunscreen.

Skin cancer within Canada

The incidence of skin cancer varies by province, with some surprising differences even in provinces located close to each other. For example, a recent study revealed that Nova Scotia (NS) and Prince Edward Island (PEI) had skin cancer rates higher than the national average, while New Brunswick (NB) had a rate similar to the national average.

In contrast, Newfoundland and Labrador (NL) had a lower incidence rate than the national average. However, the reasons behind these variations, especially among neighbouring provinces, remain unclear.

Current study

To address this, a study led by PhD Candidate Saulia Alli from the Temerty Faculty of Medicine at the University of Toronto, in collaboration with colleagues from McGill and the University of Montreal, aimed to explore the sociocultural factors influencing sun exposure habits in high-incidence Atlantic Canada regions (NS and PEI) compared to average- to low-incidence regions (NB and NL). This research was published in the journal Cancers.

The study involved 95 participants divided into 13 focus groups, where they were asked to discuss their sun-protection behaviours. All the participants were residents of an Atlantic Canada province aged 16 or older.

Study findings

From the focus groups, the researchers identified four main sociocultural factors that help explain why NS and PEI have higher skin cancer incidence rates compared to the rest of the country and the other two Atlantic provinces.

First, although more individuals from NS and PEI reported using sun protection, they also reported spending more time in the sun. Second, outdoor occupations like fishing were more common in NS and PEI. Third, NS and PEI had a greater culture of engaging in outdoor activities. Fourth, NS and PEI folk perceived their regions to have more sunny days and warmer temperatures compared to individuals from NB and NL.

These findings align with the concept of the “sunscreen paradox”, where people who are more aware of sun exposure tend to use more sunscreen (as seen in NS and PEI), but paradoxically expose themselves more frequently to sunlight, possibly due to a false sense of security provided by sunscreen. This puts them at a greater risk of skin cancer, especially when compared to residents of NB or NL.

Furthermore, the geographical characteristics of NS and PEI, being smaller and surrounded predominantly by water, result in more exposure to UV radiation. This is because sunlight near water and sand intensifies UV radiation more than in areas with more grassland, such as most of NB and half of NL.

Where to go from here?

The authors recommend increased public education concerning sun protection and associated sun exposure risks. They advocate for the promotion of sun-protective clothing in conjunction with sunscreen use during sun exposure. The study also suggests the creation of more government-funded shaded areas and the elimination of taxes on sun-protective items to enhance accessibility.

Overall, this research underscores the significant role of sociocultural factors in influencing high skin cancer incidences in Atlantic Canada, and highlights potential nationwide public health interventions to potentially reduce the impact of skin cancer. By understanding these dynamics, we can work toward a future of reduced skin cancer rates.

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Alexandria (Alex) Samson is a PhD student in the Department of Psychology at the University of Toronto. She completed her BSc in Neuroscience from Dalhousie University. Alex is a strong believer in open science and is passionate about making scientific research accessible to all audiences.