New light shone on skin cancer

The most likely Australian to have skin cancer is a Queensland man over the age of 55, new research has found

Scientists from QIMR Berghofer Medical Research Institute have for the first time comprehensively documented the burden of skin cancer across Australia, highlighting regional and age-related characteristics of patients who had a cancerous skin lesion removed.

A key finding of the study, published in the Medical Journal of Australia, was the frequency with which people had more than one skin cancer removed, QIMR Berghofer Cancer Control Group leader Professor David Whiteman says.

Almost 4% of Australians aged over 20 had a non-melanoma cancer removed between 2011 and 2014 – and of those, almost half had more than one skin cancer excised.

“We found that 74% of all skin cancers that were removed came from just 47% of Australians who had skin cancer treatment. In other words, the vast majority of skin cancers arose in a relatively small pool of people.

“In raw numbers, this means more than 183,000 skin cancers that were removed over a four-year period came from just 47 per cent of the total population who had skin cancers excised.”

Professor Whiteman said the study found more men than women had multiple skin cancers removed, particularly men aged over 70 years.

“We also found that Queenslanders were significantly more likely to have multiple skin cancers than residents of other states,” he said.

“Having a big-picture view of the impact of multiplicity is useful not only for individual doctors, but also for those who plan health services and make policy.

“Multiple skin cancer lesions are a big driver of pain and suffering, as well as costs to the healthcare system.”

Basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) cause more than 95,000 hospital admissions each year in Australia and account for more than 500 deaths.

BCCs and SCCs, which are non-melanoma skin cancers, together impose the second highest cost of all cancers on the Australian health budget, after colorectal cancer.

Professor Whiteman’s study of the prevalence of skin cancer in the Australian population was analysed using de-identified Medicare data overlaid with histology information from his work on the world’s largest prospective cohort study of skin cancer, QSkin.

“This study is the most comprehensive picture of the occurrence of these cancers by age, sex, state and prior history of skin cancer,” he said.

“Our results show that by the age of 70 years, around half of all Australian men treated for skin cancer will have another excision within four years.

“In Queensland, rates were nearly twice the national average and almost three-fold higher than Victoria and Tasmania.

“The reported rates are very high when compared on a global scale and underscore the sheer size of the skin cancer burden within the Australian population.”

Heather Walker, chair of the Skin Cancer Committee at Cancer Council Australia, said that the incidence of non-melanoma skin cancers was worrying.

“Australia has one of the highest rates of skin cancer in the world and people diagnosed with non-melanoma skin cancer often have more than one,” she said, responding to the study.

“This was estimated to cost the Australian health system a whopping $703 million in 2015. But the good news is that skin cancer is highly preventable, and, if caught early, most can be successfully treated.

“So the message is clear: use sun protection, keep an eye on your skin and go to the doctor if you notice anything unusual.

“Cancer Council is calling on the Federal Government to fund a skin cancer awareness campaign to remind Australians that being SunSmart is just as important as ever.”

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