While incidences of skin cancer in Asia are small in comparasion to that of the US and Australia, the number of cases have jumped markedly in recent years, writes Tan Ee Lynin Hong Kong
It's autumn in Hong Kong but the island's beaches are still crowded with sun worshippers desperate to catch the last rays of sunshine before winter.
"I love the bronze colour," says sunbather Richard Tong.
A growing trend in East Asia to soak up the sun either on beaches or in tanning salons is worrying dermatologists in the region, who say they are seeing a rise in skin cancer, which is caused by cumulative over-exposure to the sun.
The number of cases is low compared to the US and Australia but the tanning trend has raised concern of cancer risks in a region where a porcelain complexion was traditionally considered the ultimate sign of beauty and refinement.
"Asians, including South Koreans, used to think they were pretty safe from skin cancer. However, due to increased outdoor activity, more [ sun] exposure and sun tanning, there is an increasing incidence of skin cancer among younger people," says Ro Young-suck, head of the Korean Dermatologist Association.
"There has been a huge increase in skin-cancer rates in Korean men in particular. We predict it's because while most Korean women usually wear sunscreen while putting on their makeup, men aren't used to this, aren't aware how dangerous it is, and so they don't bother to."
The number of cases of skin cancer has jumped markedly in recent years.
There were 1,712 new cases of skin cancer diagnosed in South Korea in 2005, up from 777 in 1995, according to the Korea Central Cancer Registry.
Incidences in Hong Kong went up to around 650 in 2004 from 370 in 1995.
"People who are constantly exposed to UV [ ultraviolet radiation in sunlight] won't get cancer immediately," says George Li, a plastic surgeon at Hong Kong's public Queen Mary Hospital.
"It takes a long time to cause skin damage; as people get older, there is a high chance of developing skin cancer."
Skin cancer is one of the most common forms of cancer and is linked to other risk factors, such as fair skin, light coloured hair and eyes, a compromised immune system, genes and old age.
There are three major types of skin cancer: basal cell carcinoma, squamous cell carcinoma and melanoma. The first two are slow growing and highly treatable if discovered early.
Melanoma is the most lethal. It affects deeper layers of the skin and can quickly spread to other parts of the body. It causes eight out of every 10 skin-cancer deaths in the US.
Caucasians are more susceptible to skin cancer and an average of one in three Caucasians gets skin cancer in their lifetime, according to the US Skin Cancer Foundation.
In Asia, sun worshippers don't just work on their tans on the beach or by the pool - tanning salons are becoming increasingly popular as beauty salons offering a range of treatments take off in a region that is enjoying unprecedented affluence.
A 15-20 minute session costs anywhere between S$35 and S$60 (€17- €29) in Singapore. In Hong Kong, a 10-minute session costs about $13 (€9).
Even in Australia, where one in two Australians develop skin cancers in their lifetime and 1,600 people die from skin cancers each year, a campaign to educate people to wear sunblock, sunglasses and shirts to reduce skin cancer risks does not seem to be making major dents in skin-cancer rates.
Melanoma cases in Australia rose nearly 7 per cent in women in the 10 years to 2003, and nearly 19 per cent in men.
Although Cancer Council Australia president Prof Ian Olver expects skin cancer figures to flatten out when the younger generation, educated to cover up from the sun, gets older.
"Caucasians migrated into an area where the sunshine is intense. In other countries, indigenous people have pigmented skin because of the climate they lived in over the years. We migrated to a country that didn't suit our skin colour," Olver says.
In Hong Kong, George Li tries to educate locals by telling them to cut sun exposure, use sun-block rather than tanning creams and avoid sunbeds - which use mainly ultraviolet A rays.
"UV-A is not completely innocent, we cannot completely disregard it. We are exposed to a lot of UV-A and because of its high wavelength, it penetrates deeper," he says.