The problem of skin cancer in Australia began over 200 years ago when the first fair-skinned Europeans settled on the shores of Sydney Harbour in 1788.
At least 2 in 3 Australians will be diagnosed with some form of skin cancer before the age of 70. 1 The risk is higher in men than in women (70% vs. 58% cumulative risk of NMSC before age 70 1; 58.5 vs. 39.0 age-standardised incidence rate of melanoma2). The risk of mortality is also higher for men - 69% of Australians who die from skin cancer are men. 3
Australia has one of the highest rates of skin cancer in the world. This is due largely to our climate, the fact that many of us have fair skin that isn’t suited to such harsh conditions, our proximity to the equator (high UV levels) and our social attitudes and love for the outdoors.
In 2013 over 2200 Australians died from skin cancer (ABS Causes of Death, 2013).
The good news is that skin cancer can be prevented and we can all minimise our life time chances of developing skin cancer by being SunSmart and getting to know our skin better.
Who is at risk?
Everyone in Australia is at risk of developing skin cancer due to our high levels of UV radiation throughout the year. However skin cancer risk is categorised into average risk, increased risk, and high risk by the Royal Australian College of General Practitioners. 4
You are at increased risk of developing skin cancer if you have:
- lots of moles or freckles
- fair skin that burns easily and does not tan
- light coloured eyes (blue or green), light coloured hair (blonde or red)
- suffered sunburns, particularly as a child
- a family history of skin cancer
- used solaria
- spent lots of time in the sun, even if sunscreen was used.
Non-melanoma skin cancer (NMSC)
NMSC is the most common cancer in Australia. Cases of NMSC are not routinely reported to state and territory cancer registries however obtained from population surveys including Medicare records. It has recently been estimated that there are over 760,000 cases (treatments not people) of non melanoma skin cancers in 2010, this is equivalent to over 2000 treatments every day, and this figure is set to climb further before it declines. NMSC is often self detected and are usually removed/treated in doctor’s surgeries.
In 2013 there were over 500 NMSC related deaths reported (416 males and 176 females) (ABS: Causes of death 2013. 2015). The estimated total treatment cost for non-melanoma skin cancer during 2010 was $500 million making skin cancer, in financial terms, the most costly cancer burden to the health system. This figure is expected to reach $700 million in 2015.
According to the AIHW statistics for 2007, despite the high incidence rate of non-melanoma skin cancer, the age-standardised mortality rates are relatively low at 8.5 per 100,000 population for males and 3.4 per 100,000 for females, compared with the high mortality rates of male lung cancer at 46.3 per 100,000 population, prostate cancer (31.0 per 100,000), and female breast cancer (22.1 per 100,000) (AIHW Cancer incidence projections, Australia 2011 to 2020.2012).
In 2012 the Medical Journal of Australia reported the total number of NMSC treatments increased from approx 412,493 in 1997 to 767,347 in 2010, the authors estimated the number of NMSC treatments would increase to 938,991 in 2015. The cost estimate (which does not include the patient's out of pocket expenses) was half a billion dollars in 2010 (Fransen M, et al. 2012).
Melanoma in Australia
Recent Australian Institute of Health and Wellfare (AIHW 2014) reports indicate that over 11,500 Australians were diagnosed with melanoma in 2011 (6,734 men and 4,835 women) making melanoma the fourth most common cancer diagnosed in Australia (behind prostate, bowel and breast cancer).
There were over 1,600 melanoma recorded deaths in 2013 (1,107men and 510 women) (ABS, 2015). Melanoma accounts for approx 11% of all cancers diagnosed in Australia (AIHW 2008) and is the third most common diagnosed cancer in men and women (AIHW. Cancer in Australia 2014).
Incidence has increased by 151% in males and 46% in females between 1982 and 2007. However, how much of this increase is due to a real increase in the underlying disease, and how much is due to improved detection methods, is unknown (AIHW 2012).
While only a small proportion of total melanoma cases are diagnosed in people under 35 years of age, Australian adolescents have by far the highest incidence of malignant melanoma in the world (one-third of cancers in females, one-quarter in males), compared with adolescents in other countries (Stiller CA 2007). Furthermore, melanoma is the most common cancer diagnosed in Australians aged 15-29 years, and accounts for more than one-quarter of all cancers in this age group (AIHW 2011).
Over 8% of melanoma cases are diagnosed in people aged under 35 years old, 28% in those aged 35-54, 41% in those aged 55-74 and 23% in those aged 75 or older (AIHW, 2008).
The Economic Impact
According to the Australian Institute of Health and Welfare, skin cancer cost the health system around $300 million annually in 2001 ($264m non-melanoma and $30m melanoma) - the highest cost to the system of all cancers.
The estimated total treatment cost for non-melanoma skin cancer (NMSC) during 2000-01 was $264 million. In 2010 it was calculated that the total cost of NMSC (diagnosis, treatment and pathology) was $511.0 million. In 2015 NMSC treatment has been estimated to increase to $703 million. Click here for references.
1. Staples MP, Elwood M, Burton RC, Williams JL, Marks R, Giles GG. Non-melanoma skin cancer in Australia: the 2002 national survey and trends since 1985. Med J Aust 2006 Jan 2;184(1):6-10 [Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/16398622].
2. Fransen M, Karahalios A, Sharma N, English DR, Giles GG, Sinclair RD. Non-melanoma skin cancer in Australia. Med J Aust 2012 Nov 19;197(10):565-8 [Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/23163687
3. Australian Bureau of Statistics. 3303.0 - Causes of Death, Australia, 2013. Canberra: Australian Bureau of Statistics; 2015 Mar 31 [cited 2015 Mar 31]. Report No.: 3303.0. Available from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/3303.0.
4. Royal Australian College of General Practitioners. Guidelines for preventive activities in general practice. East Melbourne, Australia; 2012.