Abstract
ObjectivesWe described incidence trends of keratinocyte carcinomas (KCs)—namely basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)—in the Australian state of Tasmania.MethodsWe identified histologically confirmed KCs within the Tasmanian Cancer Registry (TCR) and conducted assessments to ensure data quality. Age-standardised incidence rates were calculated for first (1985–2018) and annual KCs (1978–2018). Average annual percentage changes were computed using Joinpoint regression models.ResultsThe TCR is a reliable source of KC data. A total of 83,536 people were registered with a KC between 1978 and 2018. Age-standardised incidence rates of first KCs increased on average by 3% per annum for BCCs and 4% per annum for SCCs, reaching 363/100,000 and 249/100,000 in 2018, respectively. Age-standardised incidence rates of annual KCs increased on average by 5% per annum for BCCs and 6% per annum for SCCs, up to 891/100,000 and 514/100,000 in 2018, respectively. This increase was steeper for females than males and highest during the late 1980s and early 1990s. A change in trend around 2014 suggested that incidence rates have started to decline.ConclusionWhile the incidence of KCs in Tasmania increased substantially over 41 years, rates have recently plateaued and started to decline. The findings may reflect changes in sun exposure behaviours due to awareness campaigns, but high incidence rates in 2018 indicate that KCs still pose a substantial burden to this population.
Highlights
Skin cancer is the most common type of cancer in fair-skinned populations and Australia has the highest incidence in the world [1]
Compared with the gold standard of manual registration, the automated coding system misclassified less than 1% of basal cell carcinoma (BCC) and 1% of squamous cell carcinoma (SCC) notifications (Online Resource 1)
We identified 20 keratinocyte carcinomas (KCs) notifications that had not been received by the Tasmanian Cancer Registry (TCR), representing 2% and 0.5% of the total notifications in 1995 and 2000, respectively
Summary
Skin cancer is the most common type of cancer in fair-skinned populations and Australia has the highest incidence in the world [1]. Known as keratinocyte carcinomas (KCs), basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (SCC) are the most prevalent cancers in Australia. Based on national survey data collected in 2002, the risk of being diagnosed by age 70 years was estimated at 70% for men and 58% for women [2]. With an age-standardised mortality rate of 1.9/100,000 (including rare types of non-melanoma skin cancers), KCs are rarely life threatening and account for only 1.2% of all cancer deaths [3]. KCs represented 8% of all cancer-related healthcare system costs in 2008–09 [4], $127.6 million over 959,243 benefits claimed in 2014 through Medicare—Australia’s publicly-funded universal healthcare insurance scheme—and 114,722 hospitalisations in 2013–14 [3]
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