Introduction 1 2 3 4 2 Recent trends in melanoma in Australia Based on data for 109,062 invasive melanomas assembled by the Australian Institute of Health and Welfare from cancer registries in all Australian states and territories, trends in incidence of cutaneous melanoma in Australia 1982–1999 by sex and site were examined. Sites of invasive melanoma were pre-classified by cancer registries according to a standard protocol. For each site annual notifications were provided with age in 5-year bands. Population estimates by age and sex were obtained for each year from the Australian Bureau of Statistics. Annual sex-specific incidence rates of melanoma age-standardized to the WHO World Population were computed for each site and relative rates of increase were calculated for three age bands, less than 40 years, 40–59 years and 60 years and over, by regressing the logarithms of these rates on years. 1 1 Table 1 Age-standardized incidence of melanoma on head and neck sites and all sites in Australia 1982–1986 and 1995–1999 by age and sex Site Age (years) No. of melanomas Incidence rates per 100,000 % Annual relative increase (95% CI) 1982–1986 1995–1999 Males Ear <40 179 0.15 0.22 2.0 (−0.9–5.0) 40–59  426 0.95 1.31  1.9 (0.0– 3.8) ≥60  1,115 3.29 6.46 4.2 (3.0– 5.4) Face <40  392 0.34 0.50 2.6 (−0.7–4.5) 40–59  1,125 2.48 3.85  3.2 (2.1–4.4) ≥60  3,546 11.06 20.30 3.7 (3.0–4.4) All sites <40  10,731 8.91 11.98 1.4 (1.0–1.8) 40–59  19,898 43.38 64.65 2.8 (2.5–3.1) ≥60  27,957 85.34 166.53 4.4 (4.2–4.6) Females Ear <40  106 0.08 0.17 6.1 (2.4–9.9) 40–59  130 0.23 0.53 7.0 (3.6–10.4) ≥60  226 0.58 0.92 1.9 (−0.8–4.6) Face <40 451 0.40 0.54 0.9 (−0.9–0.7) 40–59 840 2.48 2.34 0.0 (−1.3–1.4)  ≥60 3,508 9.73 15.28 2.4 (1.8–3.1) All sites <40 13,494 13.49 15.29 0.3 (0.1–0.7) 40–59 17,328 44.24 54.69 1.5 (1.2–1.8) ≥60 19,654 55.74 87.05 2.9 (2.6–3.2) Recent site-specific trends in melanoma on the head and neck in Australia 1 1 Sex-specific differences in incidence rates of melanoma on the head and neck 1 2 2 5 Hypothesis 1 Fig. 1 Measurement of solar ultraviolet radiation on ears in relation to hair cover using head-forms and polysulfone dosimeters  Ears covered by hair received on average 81% [SE ±8] less solar UV radiation than bare ears when exposed to the sun. As a control site on the face, the corresponding solar UV exposures to the noses of the manikins were monitored (Fig. 1) and showed a slight variation during the experiment in the reverse direction, namely a 5% [SE ±3.4] increase in UV radiation to the wigged manikins compared with the bare manikin. Discussion These experimental data support our hypothesis that hair cover offers substantial sun protection of the skin of the ear and by extrapolation, the skin of the scalp and back of the neck as well if hair is worn long. Taken together with the recently observed change in incidence of invasive melanoma on the ear in women in Australia and the consistent pattern in Australia and the United States of lower incidence of melanoma in females on the scalp, ear and neck – sites that are more frequently covered or screened by hair than in males, the evidence suggests that hair cover can indeed protect against invasive melanoma on these sites. 6 7 8 9