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Australia; QLD
News release
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A person with skin cancer in Australia is more likely to be a man aged over 55 years who also hails from Queensland, new research shows.
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.
QIMR Berghofer Cancer Control Group leader Professor David Whiteman said a key finding of the paper, published in the Medical Journal of Australia, was the frequency with which people had more than one skin cancer excised.
He found that almost seven per cent of all Australians aged over 20 had a non-melanoma skin cancer removed between 2011 and 2014 and of those, almost half had more than one skin cancer cut out.
“A key finding was the significance of multiple lesions for patients. That is, the frequency with which people have more than one skin cancer,” Professor Whiteman said.
“We found that 74 per cent of all skin cancers that were removed came from just 47 per cent 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.”
Expert Reaction
These comments have been collated by the Science Media Centre to provide a variety of expert perspectives on this issue. Feel free to use these quotes in your stories. Views expressed are the personal opinions of the experts named. They do not represent the views of the SMC or any other organisation unless specifically stated.
Michael Kimlin is Professor of Cancer Prevention at the University of the Sunshine Coast
This study provides strong evidence for the significant burden that sun-induced cancers have within the Australian community. It highlights how much greater the burden is for these cancers and how it varies with location.
The sunnier areas of Australia have much higher rates, than the less sunny states (twice as high in QLD compared with TAS). This study for the first time puts a number on these cancers. Significantly, this shows that 74 per cent of all cancers removed, were from people treated with multiple lesions.
This study did not use cancer registry data. In Australia these cancers are not collected in our registries so Medicare data was used for excisions. This study excluded cancers that were destructed or treated chemically – so the estimations are quite conservative.
The impacts of this study are important for the Australian community:
- Skin Cancer Prevention is critical to this story. We need to focus more on prevention of these cancers through education and awareness;
- The paper did not cover this point, however, the financial cost of these cancers is significant – now we know how many people are effected;
A significant number of people get multiple cancers, thus increasing the burden.
Today's research gives us a clear picture of the huge impact of non-melanoma skin cancer on Australians, with men and older people having the highest rates. Worryingly, these cancers are very common, with around 7 percent of adults having one removed in a three year period.
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. 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.
Bruce Armstrong is an Adjunct Professor in the School of Global and Population Health at the University of Western Australia, and Emeritus Professor in the School of Public Health at the University of Sydney
At last we have a credible indication of how large the burden of multiple keratinocyte cancers of the skin (also referred to as non-melanoma skin cancers) are in Australia.
The most important finding of this newly published paper, based on individually linked Medicare data for removal of skin cancers, is that 74 per cent of all keratinocyte cancers cut out in Australia in 2011 to 2014 were taken from someone who had already had one (or more) of this kind of cancer removed.
While just over half of people who had any of these cancers removed in 2011 to 2014 had only one removed, about 20 per cent had two removed, ten per cent had three removed, five per cent had four removed, three per cent had five removed and so on. Some people had more than 20 removed! And the older you are, the worse it gets.
While, arguably, having one of these skin cancers removed is a trivial matter, having lots removed is not. It is a substantial burden, often causes substantial disfigurement and carries with it the threat of more to come.
Consistent use of sunscreen on all sun-exposed skin when the UV Index is 3 or more (or just every day anyway), particularly on the face, forehead, ears, neck, backs of hands and forearms, can prevent these cancers. It is never too late to start.
