Skin cancer in Australia

Key points

•Melanoma is the most dangerous form of skin cancer. Melanoma kills more young Australians than any other cancer, and is caused predominantly by over-exposure to the sun.

•Skin cancer occurs when skin cells are damaged by overexposure to ultraviolet (UV) radiation from the sun. There are different types of skin cancers, with melanoma being the most dangerous.

•Australia has one of the highest melanoma rates in the world with Queensland having the highest rates among the states and territories. Excluding non-melanoma skin cancer, melanoma is the third most common cancer in Australians.

•Melanoma is the most common cancer in young Australians (15–39 year olds) making up 20% of all their cancer cases. Melanoma kills more young Australians (20–39 year olds) than any other single cancer.

•By the time they reach 70, two in three Australians will have been diagnosed with skin cancer and each year more than 750 000 of them are treated for one or more nonmelanoma skin cancers.

Source: Cancer Council Australia (January 2018). Skin cancer.
Accessed 24 November 2018 from http://www.cancer.org.au/about-cancer/types-of-cancer/skin-cancer.html)

Find out more about skin cancer prevention

At a glance—Skin cancer

About skin cancer

What it is

Skin cancer is a disease of the body’s skin cells. It is usually caused by the sun’s ultraviolet radiation damaging the skin cells. When the skin cells die or are damaged, more skin cells are produced to replace them. Sometimes, this regrowth becomes disordered and cells multiply and form a tumour (or growth). The tumour can continue to grow and destroy healthy cells.

The impact of the sun’s rays

Each time the skin is exposed to ultraviolet radiation (UVR) from the sun, changes take place in the structure and function of the skin cells. Over time, the skin cells can become permanently damaged. This damage gets worse with each exposure to ultraviolet radiation and increases the risk of skin cancer when new skin cells are produced to replace the damaged ones.

How it spreads

Cancer cells can break off from the tumour and can be carried to other parts of the body by the bloodstream or lymphatic system. These cancer cells can then multiply and form other tumours in other parts of the body, including the brain, liver and lungs.

People most at risk

All skin types can be damaged by exposure to ultraviolet radiation. Excessive exposure in the first 20 years of life is very dangerous. While some people such as naturally dark (or olive) skinned people have skin types that are less likely to burn, they are still at risk of developing skin cancer. However, the risk is lower. Dark-skinned people still get skin cancer, but their skin cancers may develop in unusual places, for example under their fingernails or on the soles of their feet.

Skin cancer sites

Skin cancers can occur anywhere on the body, but are usually found on those parts of the body that are regularly exposed to the sun:

For both males and females, the face and arms are the areas of the body most commonly affected by non-melanoma skin cancer.

Males often develop dangerous melanomas on the back and shoulders.

Females often develop dangerous melanomas on their legs.

Note that melanomas are not confined to these sites. Skin cancers can occur anywhere, but they are rarely found on areas of skin that are always shielded from the sun.

Types of skin cancer

There are three main types of skin cancer:

Melanoma

•Most dangerous but least common type of skin cancer.

•If treated early, nearly all melanomas can be cured.

•If left untreated, cancer cells can spread throughout the body.

•Cause most deaths from skin cancer.

•Warning signs include:

–a new spot or existing spot that changes

–a mole that grows quickly

–a mole that changes in colour or shape

–a skin spot that bleeds easily or itches.

Squamous cell carcinoma (SCC)

•Non-melanoma skin cancer that is common.

•Can spread to other parts of the body if left untreated.

•Can nearly always be cured.

•Warning signs include:

–flat scaly patches or sores that won’t heal and might bleed easily.

Basal cell carcinoma (BCC)

•Non-melanoma skin cancer.

•Most common form of skin cancer.

•Easily treated in most cases.

•Can be disfiguring if left untreated.

•Warning signs include:

–a small lump or scaly patch that might

·have a pearly appearance

·become ulcerated.

Adapted from About skin cancer at www.sunsmart.com.au/skin-cancer/about-skin-cancer

Download Fact file A: At a glance—Skin cancer

At a glance—Skin cancer statistics

Incidence of melanoma in Australia
(number of NEW cases per 100,000 people)

•The Australian incidence rate of melanoma (number of new cases per 100,000 people) is one of the highest in the world. There were:

–14 320 estimated new cases in 2018 (8653 males and 5667 females)

–13 283 estimated new cases in 2016 Australia (7847 males and 5436 females)

–12 510 new cases in 2012

•Queensland has the highest incidence rate for melanoma in the world. Each year around 3700 new cases are diagnosed. However, as at 2016, after 30 years of prevention campaign the rates were:

–plateauing in those aged 40–59 years

–declining in those under 40 years of age.

Sex

•Melanoma is more common in males (approximately 60 new cases per 100,000 persons in 2018) than females (approximately 40 new cases per 100,000 persons in 2018).

Mortality (deaths) in Australia due to melanoma

•From 1982 to 2016, the mortality rate (number of deaths per 100,000 people):

–dropped for the three youngest age groups (0–39 yrs, 40–49 yrs, 50–59 yrs)

–increased for the three oldest age groups (60–69 yrs, 70–79 yrs and 80 yrs and over)

•The number of deaths in the same period increased for all age groups except those aged under 40 years:

–For people 0–39 years of age, deaths dropped from 93 in 1982 to an estimated 50 deaths in 2016—for this age group, the number of deaths has been progressively decreasing since 1995. This is attributed to the many sun protection campaigns and sun protection policies e.g. in schools that have been in place for most of their lives. However, melanoma is the most common cancer in 15–39 year-olds, making up 20% of all their cancer cases.

–For those aged 40–59 years, the declining mortality rate (number of deaths per 100,000 people) was offset by the population increasing by approximately 50% in this period so the actual number of deaths increased.

–For those aged 60 years and over, both the increased mortality rate as well as the growth in population in this age group contributed to an increase in the number of deaths.

•The number of deaths per year from melanoma among people over 40 years of age continues to increase and is expected to for many years due to unprotected UVR exposure in younger years.

•In Queensland, where the mortality rate is highest:

–310 people died from melanoma in 2016

–390 died from melanoma in 2013.

Table 1. Number of deaths in Australia due to melanoma from 1996 to 2018

	Males	Females	Total
** Australia 2018 (estimated)	1331 (70%)	574 (30%)	1905
* Australia 2016 (estimated)	1230 (69%)	545 (31%)	1770
** Australia 2013	1107 (69%)	510 (31%)	1617
* Australia 2012	1070 (68%)	495 (32%)	1560
** Australia 2011	1071 (69%)	473 (31%)	1544
Australia 1996	580 (64%)	323 (36%)	903

* AIHW Skin Cancer website
** Australian Government Cancer Australia website

Table 2. Number of deaths in Queensland due to melanoma from 2002 to 2016

	Males	Females	Total
Queensland 2016	209	101	310
**** Queensland 2013	287	103	390
*** Queensland 2012	214	97	311
*** Queensland 2011	225	93	318
*** Queensland 2002	132	64	196

*** Queensland Cancer Registry and Cancer Council Queensland (2014).
**** AIHW (2015). Cancer in Queensland, Incidence, Mortality, Survival and Prevalence, 1982 to 2013.

Table 3. Number of deaths and mortality rates for melanoma, by state and territory, 2008–2012

State or territory	Total number 2008 to 2012	Age-standardised rate (per 100 000)
Queensland	1694	7.5
New South Wales	2545	6.3
Western Australia	703	6.2
Tasmania	188	5.9
Australian Capital Territory	95	5.9
Victoria	1539	5.1
South Australia	511	5.0
Northern Territory	25	3.1
Total	7300	6.1

Source: AIHW National Mortality Database.

The table shows that from 2008–2012:

•the number of deaths from melanoma ranged from 25 in the Northern Territory to 2545 in New South Wales, with the variation largely due to the size of the population in each jurisdiction

•Queensland had the highest age-standardised mortality rate (7.5 deaths per 100 000) and the Northern Territory had the lowest (3.1 per 100 000). The lower mortality rate in the Northern Territory might be partly due to its higher proportion of Indigenous residents.

Download Fact file B: At a glance—Skin cancer statistics

Skin cancer in Australia

Key points

At a glance—Skin cancer