29 November 2017

Here’s more good news on skin cancers

Cancer Clinical

Australia’s investment in sun awareness and progress in melanoma detection are paying off, experts say, citing better recovery rates and a dip in the incidence of deadly cancer.

Dr Kerry Crotty, a Sydney-based dermatologist and pathologist, said advances in diagnostic technology and expertise were behind earlier diagnosis of skin cancers, with better outcomes for patients.

“I think we are picking up melanoma a lot earlier than we used to, both because people get their skin checked and we are better at picking them up,” she told a forum on skin cancer to mark International Pathology Day.

“Because we have such a high incidence of skin cancer in Australia, most GPs have a fairly good understanding of skin cancer and most GPs are good at picking it up,” Dr Crotty added.

Professor Richard Scolyer, co-medical director of the Melanoma Institute of Australia, said if melanoma was treated early enough, it could in most cases be cured.

“That creates a challenge for us as pathologists to diagnose melanoma accurately at an earlier stage.

“Melanoma is the most common cancer in 15- to 39-year-old Australians, and the most common cause of [cancer] death,” he said.

Research published last year in the Journal of Investigative Dermatology concluded that Australia’s melanoma incidence had peaked in 2005.

The research team, led by Professor David Whiteman, of the QIMR Berghofer Medical Research Institute, compared melanoma incidence trends in five countries with predominantly European populations as well as data on the incidence among US whites.

“We found melanoma incidence in Australia peaked around 2005, and have been declining at a significant 0.7% p.a. since then.  In comparison, rates in all other populations have been rising significantly year on year,” Professor Whiteman told The Medical Republic.

“In birth cohort analyses, it was evident that the declines in melanoma incidence were most pronounced in the young – suggesting that this younger generation of Australians are residing in a different ‘risk environment’ from previous generations.”

Based on the timing of the declines and other factors, the most plausible explanation was the nationwide sun protection campaigns that commenced in the 1980s, he said.

Other explanations, such as “population dilution” by immigration of less susceptible populations, probably played a role, but only a minor one in the overall scheme of the decline.

Australia was the only population group studied to show declines in melanoma incidence. The other countries subject to the research were New Zealand, the UK, Sweden and Norway.

In New Zealand, the incidence was projected to decline soon, the research team concluded.

However, the number of melanoma cases in all six populations was expected to keep rising through 2031 owing to broader population growth and ageing, increasing the challenge of melanoma control, the paper said.