Skin Cancer in Australia
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 and of course our social attitudes and love for the great outdoors. Each year over 1700 Australians will die from skin cancer (ABS 2009). At least two in three Australians will develop skin cancer by the age of 70. The good news is that we can minimise our chances of developing skin cancer by being SunSmart.
Who is at risk?
Everyone in Australia is at risk of developing skin cancer due to high levels of UV radiation throughout the year.
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.
Types of skin cancer
There are three main types of skin cancer named after the type of cell they develop from: basal cell carcinoma, squamous cell carcinoma and malignant melanoma.
Basal cell carcinoma and squamous cell carcinoma are also known as non-melanoma skin cancer (NMSC).
 Basal cell carcinoma (BCC):
- are the most common type, accounting for about two-thirds of skin cancers
- grow slowly over months or years
- usually appear as small, round or flattened spots that are red, pale or pearly in colour
- can be scaly like a patch of eczema
- may look like an ulcer or sore that doesn't heal
- incident rates increases with age, however BCC can occur in people as young as their 20s.
Squamous cell carcinoma (SCC):
- account for about one-third of skin cancers
- can grow quickly over several months
- are usually scaly red areas that may bleed, ulcers or non-healing sores that may be painful
- appear on skin most often exposed to the sun
- tend to occur from the age of 40 onwards, incident rates increase with age
- on the lips and ears have a high risk of spreading
- are not as dangerous as melanoma, but they can spread to other parts of the body if left untreated. If you are concerned about a spot that won't heal see your GP immediately.
Melanoma:
- are the least common but most aggressive form of skin cancer
- grow and spread rapidly
- can start in normal looking skin, or in a freckle or mole
- can grow anywhere in the body - not just areas exposed to the sun
* if treated early,95% of melanomas can be cured.
* Note: not all skin cancers look like the photographs above, these are for illustrative purposes only.
Nodular melanoma
Nodular melanoma is a highly dangerous form of melanoma, because it grows very quickly in depth than other melanomas and can be life threatening if not detected early.
- grows quickly, in some cases can become life threatening in 6-8 weeks
- usually appears as a new small lump on the skin which may be black, brown, pink or red in color.
Other spots to watch for
Dysplastic naevi
Dysplastic naevi are moles that have an irregular shape and have an uneven colour. People with many dysplastic naevi are more likely to develop melanoma. If you have these moles, you should regularly check for any changes and look for new spots on the skin. If you notice any changes, you should see your doctor immediately.
Solar keratoses (sunspots)
- usually occur in people aged over 40
- appear on the head, neck, arms and legs
- usually flattish, scaly patches
- may be pale or red, and may sting if scratched
- may develop into squamous cell cancers.
They are not a skin cancer but they can be a pre-curser for squamous cell carcinoma and a risk factor for basal cell carcinoma and melanoma. They appear on sun exposed skin usually in people aged 40 and over, and are a sign that the body has had a lot of exposure to ultraviolet radiation (UVR).
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 suggest that approximately 434,000 Australians will be treated for non-melanoma skin cancer each year (AIHW, 2008).
In 2008 it was projected that 253,000 males and 180,000 females will be diagnosed with one or more NMSC. NMSC is often self detected and are usually removed in doctor’s surgeries.
In Australia in 2007 there were 448 deaths reported from NMSC (305 males and 143 females) (ABS: Causes of death 2007, 2009)
The estimated total treatment cost for non-melanoma skin cancer during 2000-01 was $264 million making skin cancer, in financial terms, the most costly burden to the health system. An additional $30 million was spent on melanoma treatment.
Despite the high incidence rate of NMSC, mortality rates are relatively low at 3.2 per 100,000 population for males and 1.0 per 100,000 for females (AIHW, Cancer in Australia, 2008)
Melanoma in Australia
Recent reports indicate that 10,684 Australians were diagnosed with melanoma in 2005 (6,044 men and 4,640 women) making melanoma the fourth most common cancer diagnosed in Australia (behind prostate, bowel and breast cancer) (AIHW 2008). There were 1279 recorded deaths from melanoma in 2007 (864 men and 415 woman) (ABS, 2009). Melanoma accounts for 11% of all cancers diagnosed in Australia (AIHW,2008).
Australian adolescents have by far the highest incident of malignant melanoma in the world, compared with adolescents in other countries. It is the most frequent type of cancer in both sexes, and accounts for one third of all cancers in female adolescents and one quarter in males (Stiller CA: 2007). A history of multiple severe, painful sunburns is associated with malignant melanoma (Jones LME, 2000)
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).
Melanoma in the ACT
Cancer in the ACT Incidence and Mortality (2009) reported skin melanoma as the third most common diagnosed cancer in both males and females in the ACT. According to recent cancer statistics in 2002-2006, 1 in 25 males and 1 in 35 females in the ACT developed melanoma before the age of 85 years.
A difference in mortality rates between males and females was also recorded, with females being lower. This may be due to the tendency of men tending to seek medical attention in the later course of the disease more then women, therefore decreasing their chances of survival.
The risk of dying from melanoma was one in 165 males and one in 605 females in the ACT before the age of 75 years (with one in 110 males and one in 310 females in the ACT before the age of 85 years old).
As for most cancers, incidence and mortality of melanoma increased with age. Diagnosis of melanoma before the age of 20 is uncommon, with five (5) cases recorded in the ACT between 2002-2006.
Rates in males and females were simliar until 55 years of age when rates increased sharply in males. The highest mortality rates were recorded in males over 55 years old.
There has been an upward trend in melanoma age standardised incidence rate in both ACT males and females (a similiar upward trend was also seen in NSW and Victoria).
The ACT Chief Health Officers Report- 2008 listed melanoma of skin as the 3rd most common cancer in both males and females in the ACT (11%). It was the seventh most common cause of death from cancer in males and twelfth in females.
The incidence and mortality rate for melanoma of skin in the ACT is increasing in both males and females.
To access past ACT Health reports click here.
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