Skin Cancer In Australia Research Articles

Skin cancer prevention in Australia.

Australia and New Zealand have the greatest burden of skin cancer in the world. General Practitioners (GPs) are thefirst interaction for most patients with skin cancer concerns and are well placed to provide information regarding primary and secondary skin cancer prevention. This article aims to discuss primary and secondary prevention of skin cancer in Australia. GPs can help reduce the incidence of skin cancer by identifying high-risk individuals in primary care clinics, enrolling them in a surveillance program and tailoring skin cancer prevention advice. GPs should encourage patients to practise sun safety through the use of shade, photo-protective clothing, sunglasses and sunscreen and being aware of the ultraviolet index through tools such as the SunSmart App to guide behaviours and activities.

Mortality from Nonmelanoma Skin Cancer in Australia from 1971 to 2021.

Data on the Australian population were obtained from the Australian Bureau of Statistics (ABS). Every five years a census is held in Australia and detailed information of the population is provided. The ABS also provided yearly data on the causes of death in Australia. The total population increased from 12,755,638 in 1971 to 25,738,140 in 2021. However, the susceptible population increased by far less, from 12,493,780 to 19,773,783. The number of deaths from NMSC increased from 143 to 765. The crude death rate for the susceptible population increased from 1.1 per 100,000 to 3.9 per 100,000. The crude death rate in the susceptible population aged 65 or more increased from 9.4 to 18.2 per 100,000. Deaths from NMSC are increasing despite public health campaigns to prevent skin cancer. According to current trends, NMSC will cause more deaths than melanoma in Australia.

Early detection of skin cancer in Australia - current approaches and new opportunities.

Narrative review. Building on the discussions from the Melanoma Screening Summit held in Brisbane, Australia, in 2019, we reviewed evidence related to current approaches and new opportunities for early detection of melanoma and other skin cancers. Population-based melanoma screening is not currently recommended due to insufficient evidence that screening reduces melanoma mortality. Instead, in most countries including Australia, early detection of melanoma and keratinocyte carcinomas is undertaken opportunistically, by either the patient presenting for a routine skin check or with a lesion of concern, or by the doctor detecting a lesion incidentally. Several concerns about the current unstructured approach to skin cancer early detection have been identified, including variable quality of care, sociodemographic inequalities in medical access and health outcomes, excision of many benign lesions, overdiagnosis, gaps in workforce training, and health system inefficiencies. There has also been renewed interest in melanoma screening in Australia, driven by a changing landscape of skin cancer early detection. These changes include increasing health system costs for adjuvant therapies, advances in diagnostic technologies and artificial intelligence, the availability of validated risk-stratification tools, and consumer-driven digital technologies. The future of skin cancer early detection in Australia and internationally may incorporate features such as a more structured approach to skin cancer risk assessment using online risk calculators and invitations to screen, consumer-driven melanoma surveillance, and new technologies for diagnosis and monitoring of lesions. High-quality research evidence is being generated across multiple research programs, and is essential to underpin any changes to policy and practice in skin cancer early detection.

The economics of skin cancer prevention with implications for Australia and New Zealand: where are we now?

The incidence of skin cancer, including melanoma, continues to climb in white populations around the world, imposing a large and growing burden on health systems and individuals. Harmful exposure to ultraviolet (UV) radiation, mostly solar UV, is the most avoidable cause of skin cancer risk and mortality. Many economic evaluations attest to the favourable benefits for governments and citizens from skin cancer prevention programs. This overview presents the current 'state of play' of the economics of skin cancer prevention. More research is required to document contemporary costs of managing skin cancer in Australia and New Zealand to accurately assess the true savings from primary prevention. New directions are proposed for ways that economics could contribute to the investment case for prevention. The majority of skin cancers are avoidable and curable, yet cost the Australian health economy A$1.7 billion each year. Therefore primary prevention of skin cancers must remain high on the public health agenda.

Metastatic Basal Cell Carcinoma to the Parotid Gland

Basal cell carcinoma is a very common skin cancer in Australia. It is a locally invasive neoplasm which can rarely have life threatening effects. There have been many reported cases of metastatic BCC though it is uncommon, rarer still is spread to the parotid. We present a case of a patient in Far North Queensland who had a BCC metastasize to his parotid from a close by primary.

Sun safety knowledge, practices and attitudes in rural Australian farmers: a cross-sectional study in Western New South Wales

BackgroundRates of skin cancer in Australia are amongst the highest in the world, with Western New South Wales (NSW) exhibiting very high prevalence. There is a large proportion of outdoor workers, including farmers, in Western NSW who have high levels of sun exposure and hence are at greater risk of developing skin cancer.AimsTo characterise the current sun safety practices of farmers in Western NSW and explore their knowledge, attitudes and perceived barriers towards sun safety and its implementation.MethodsA cross-sectional survey study was conducted using a self-directed questionnaire. Participants were recruited at field days held in Western NSW and through surveys distributed at general practices, local stores and online. Eligibility criteria were aged 18 years and over and currently working on a farm in the study region.ResultsOf the 144 participants, 89 (61.8%) were male with a mean age of 49 years. Knowledge of sun safety was relatively high with most questions answered correctly by greater than 80% of participants. Risk of developing skin cancer was underestimated in 58 (40.3%) participants. Of all participants, 89 (62.2%) identified one or more barriers to practicing sun safety. The most common barrier was forgetfulness in 62 (43.4%) participants. The identification of barriers was significantly associated with reduced engagement of sun safety practices (p = 0.009).ConclusionsKnowledge of sun safety among farmers was high. There was, however, underestimation of risk of developing skin cancer. Addressing perceived barriers to implementing sun safety could improve sun safety practices in this cohort.

Patients' sun practices, perceptions of skin cancer and their risk of skin cancer in rural Australia.

Skin cancer affects nearly one in three Australians. As a preventable disease there have been many public awareness campaigns targeting skin cancer knowledge and sun protection in Australia in the last 30years to increase knowledge of the disease and how to prevent it. Despite higher incidence and mortality of skin cancer in regional Australia and adults over 65years though, little research exists examining this high-risk population's skin cancer knowledge and sun behaviours, with most previous research conducted in urban Australia or overseas. This study aimed to examine adults' skin cancer knowledge, sun behaviours and demographic factors in a regional Australian town. Cross-sectional study design was utilised. Adult patients of a Mudgee General Practice (n=179, 18-89years) completed a survey based on their skin cancer knowledge and sun behaviours. Chi-squared tests were used to analyse responses. Poor non-melanoma skin cancer awareness, risky sun behaviours and inadequate sun protection behaviours were found. Males and those at greatest current risk of skin cancer in Australia, those over 60years, had the poorest skin cancer knowledge and were least likely to recognise skin cancer or use some sun protection measures. Greater non-melanoma skin cancer and sun protection education and research is needed, particularly targeting older and male Australians. SO WHAT?: The findings suggest rural men and older Australians would benefit from more targeted campaigns and education to increase their skin cancer awareness and use of sun protection in order to minimise future skin cancer.

Aspirin and nonsteroidal anti-inflammatory drug use and keratinocyte cancers: a large population-based cohort study of skin cancer in Australia.

Nonsteroidal anti-inflammatory drugs (NSAIDs) have been postulated as chemopreventive agents for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), but findings from observational studies have been inconsistent, and clinical trial data are scant. To examine the association between aspirin and NSAID (nonaspirin) use and the risk of BCC and SCC in a large cohort specifically designed for skin cancer outcomes. We used data from the QSkin Study, a prospective cohort of 43764 residents of Queensland, Australia (34630 were included in this study and 23581 were used in our primary analyses). We used Cox proportional hazards models to estimate the hazard ratios (HRs) between self-reported aspirin and NSAID use 1 year prior to study baseline and the first histologically confirmed BCC or SCC for high-risk (history of skin cancer excisions or more than five actinic lesions treated) and average-to-low-risk participants (no history of skin cancer excision and at most five actinic lesions treated). After a median of 3 years of follow-up, 3421 participants developed BCC and 1470 SCC (2288 BCC and 932 SCC with complete covariate information). Among the high-risk group (1826 BCC and 796 SCC), compared with never use, frequent (at least weekly) NSAID use was associated with reduced risk of BCC (HR 0·84, 95% confidence interval 0·71-0.99) but not SCC. Aspirin use was associated with reduced risk of SCC (HR 0·77, 95% confidence interval 0·64-0·93) only among infrequent (less than weekly) users and was not associated with BCC. We observed no association between NSAID or aspirin use and the risk of BCC or SCC among average-to-low-risk participants. While some weakly inverse associations were observed between prior use of aspirin or NSAIDs and skin cancer, the inconsistent patterns of associations do not provide convincing evidence that these medications reduce subsequent skin cancer risk. Further data on doses, duration and long-term follow-up may help us to comprehend the cumulative dose effect.

Histopathological evaluation of parotid gland neoplasms in Queensland, Australia

Parotid gland tumours are complex neoplasms with a broad histological range. The parotid gland is also a common site of face and scalp skin cancer metastases. Parotidectomies performed by ENT department in the Gold Coast health district from 2006 to 2013. A total of 158 specimens were examined. Of these, 53.80 per cent were benign and 46.20 per cent were malignant. Pleomorphic adenoma was the most common tumour (29.11 per cent), followed by cutaneous squamous cell carcinoma (23.42 per cent) and Warthin's tumour (12.03 per cent). Metastatic squamous cell carcinoma accounted for a large proportion of parotid masses in our case series, reflecting the high prevalence of non-melanoma skin cancer in Australia. Primary parotid neoplasms had similar incidence rates to other studies.

Neighbourhood green space and the odds of having skin cancer: multilevel evidence of survey data from 267072 Australians

BackgroundIf green spaces encourage people to spend more time outdoors in physical, recreational and social activities, this could have unintended but important consequences for health in countries where levels of...

Nonmelanoma skin cancer in Australia

Nonmelanoma skin cancer in Australia

Non‐melanoma skin cancer in Australia

To report the burden and cost of non-melanoma skin cancer (NMSC) treatments in Australia and to project estimates of numbers and costs to 2015. Retrospective study of data obtained from Medicare Australia for NMSC treated by excision, curettage, laser or cryotherapy between 1 January 1997 and 31 December 2010, by year, sex, age group and state or territory. Total number, total Medicare Benefits Schedule (MBS) benefit and total cost in Australian dollars of NMSC treatments. The total number of NMSC treatments increased from 412 493 in 1997 to 767 347 in 2010, and we estimated that the number of treatments would increase to 938 991 (95% CI, 901 047-976 934) by 2015. The total MBS benefit for NMSC treatments in 2010 was $93.5 million, and we estimated that this will increase to $109.8 million (95% CI, $105.9-$113.7 million) by 2015, whereas the total cost with inflation (ie, cost which includes diagnosis, treatment and pathology) was $511.0 million in 2010, estimated to increase to $703.0 million (95% CI, $674.6-$731.4 million) by 2015. NMSC treatments increased by 86% between 1997 and 2010. We anticipate that the number and the total cost without inflation of NMSC treatments will increase by a further 22% between 2010 and 2015. NMSC will remain the most costly cancer and place an increasing burden on the Australian health care system.

Fifty years of changes in UV Index and implications for skin cancer in Australia

Surface ultraviolet (UV) radiation plays an important role in human health. Increased exposure to UV radiation increases the risk of skin cancer. In Australia, public campaigns to prevent skin cancer include the promotion of daily UV forecasts. If all other atmospheric factors are equal, stratospheric ozone decreases result in UV increases. Given that Australia still has the highest skin cancer rates in the world, it is important to monitor Australia's stratospheric ozone and UV radiation levels over time because of the effects cumulative exposure can have on humans. In this paper, two long-term ozone datasets derived from surface and satellite measurements, a radiation code and atmospheric meteorological fields are used to calculate clear-sky UV radiation over a 50-year period (1959-2009) for Australia. The deviations from 1970-1980 levels show that clear-sky UV is on the rise. After the 1990s, an overall annual increase from 2 to 6% above the 1970-1980 levels was observed at all latitudes. Examining the summer and winter deviations from 1970-1980 showed that the winter signal dominated the annual changes, with winter increases almost twice those in summer. With ozone levels not expected to recover to pre-depletion levels until the middle of this century, UV levels are expected to continue to rise. Combined with Australians favoring an outdoor life-style, when temperatures are warmer, under high levels of UV, the associated risk of skin cancer will increase.

Mohs surgery in Australia: A survey of work practices

Mohs micrographic surgery is the preferred treatment for certain skin cancers. It had already been considerably refined prior to its introduction into Australia in 1978, refinement has continued since. Documenting the work practices of Australian Mohs surgeons serves to clarify the current role of Mohs surgery and may help tailor future Mohs fellowship programs. A survey was conducted to investigate the characteristics and clinical practices of Australian Mohs surgeons, particularly as they relate to skin cancer management and aesthetic dermatology. The typical Australian Mohs surgeon is male (90%), works in a group private practice (70%), and is aged 40-44 years (37%). Mohs surgery is generally reserved for tumours that are located on the head, neck, digits or genitals (98%), and flap reconstructions are the commonest repair types performed (48%). Laser and cosmetic injectable treatments form part of many Mohs surgeon's repertoires. Australian Mohs surgeons make an important contribution to the management of skin cancer in Australia and many are skilled in laser and cosmetic procedures. The increasing number of cases performed annually and the familiarity with laser and cosmetic therapies reinforces Australian dermatologists as leaders in these important areas of dermatology.

Measuring performance in skin cancer practice: the SCARD initiative

The Skin Cancer College of Australia and New Zealand (SCCANZ) has developed a unique project named SCARD - the Skin Cancer Audit and Research Database. Designed initially as a self-audit tool for primary care skin cancer practitioners, SCARD acts as a tracking tool to enhance practice safety, and it also creates practice performance reports. Pooling of de-identified data enables participating practitioners to confidentially compare their own practice to that of their peers. Additionally, this creates a large database with significant research potential, as SCARD records for every lesion de-identified practitioner and patient data, and extensive details of location, provisional and histological diagnosis, and the procedure(s) performed in its treatment. Preliminary data collected in the database have been presented in this study. An initial pool of data from 177 practitioners contains 77,553 specimens from 41,006 individual patients. The data presented are being analyzed for further studies, and additional data continues to be collected from this ongoing project. SCARD is a useful tool at practice level, and substantial uptake by Australian primary care skin cancer practitioners has provided a unique opportunity for research into skin cancer and its management. SCCANZ, a professional college of predominantly primary care medical practitioners, with a commitment to the management of skin cancer in Australia and New Zealand, has formed a partnership with the School of Medicine at the University of Queensland to ensure that these data are managed and analyzed appropriately.

Sun protection messages, vitamin D and skin cancer: out of the frying pan and into the fire?

Sun protection messages, vitamin D and skin cancer: out of the frying pan and into the fire?

Non‐melanoma skin cancer in Australia: the 2002 national survey and trends since 1985

To measure the incidence of treated non-melanoma skin cancer (NMSC) in Australia in 2002 and investigate trends since 1985 by histological type, sex, age group, latitude and skin type. Face-to-face survey between 1 January and 31 December 2002 using stratified sampling of households to identify people treated for skin cancer in the previous 12 months. Self-reported diagnoses were confirmed with treatment providers. Data from similar surveys conducted in 1985, 1990 and 1995 were used to assess trends. Whole of Australia (population 19.6 million). Of 57 215 people interviewed, 4098 said they had been treated for skin cancer in the past year and 3198 gave permission for their diagnoses to be confirmed with their doctor. 817 people were confirmed as having at least one skin cancer treated in the past year. The age-standardised rate per 100 000 population for NMSC was 1170, for basal cell carcinoma (BCC) 884, and for squamous cell carcinoma (SCC) 387. The estimated number of NMSC cases in Australia for 2002 was 374 000. Cumulative risks to age 70 years of having at least one NMSC were 70% for men and 58% for women. Rates of BCC and SCC have increased since 1985, and the increases greatest for people aged 60 years and older; rates for those younger than 60 years have stabilised. The incidence of treated NMSC in Australia in 2002 was more than five times the incidence of all other cancers combined. Although the overall NMSC rates have risen since 1985, the stabilisation of rates for people younger than 60 years who were exposed to skin cancer prevention programs in their youth highlights the importance of maintaining and strengthening these programs.

The Australian experience in sun protection and screening for melanoma.

Australia has the world's highest incidence of skin cancer. Despite excellent prevention and early diagnosis education programs and an increasing percentage of the population with darker and more UV tolerant skins, skin cancer remains a major and expensive community medical problem. However, primary and secondary prevention programs are now showing positive outcomes, especially in melanoma incidence and survival. Primary and secondary prevention programs are conducted by a variety of non-government organizations such as the Australian Cancer Council, which is comprised of state anticancer groups, with some assistance from State and Federal health agencies. Current and future campaigns are becoming focused on specific community groups, noticeably teenagers and the older population. The role of sunscreens as the primary preventative approach has been superceded by sunlight avoidance campaigns. In light of an increasing rate of early diagnosis, a low and falling morbidity of melanoma, improving general practitioner competence in skin cancer diagnosis and proliferation of skin cancer clinics throughout Australia, it is unlikely a national skin cancer screening program will be implemented. Ozone depletion, a sunlight overloaded environment, increased leisure time and an outdoor lifestyle necessitate continued efforts to minimise the cost and morbidity of skin cancer in Australia.

Misconceptions in Australian students' understanding of Ozone depletion

Declining levels of stratospheric ozone resulting from anthropogenic source gases is internationally recognized as one of the Earth’s most important environmental issues. In the last twenty years, global ozone trends show that concentrations are decreasing by 2-5% per decade in the middle latitudes. The societal concern is that with decreasing concentrations of ozone, the amount of the Sun’s ultra-violet (UV) radiation reaching the Earth’s surface will increase and potentially damage both human and other biological life. The goal of this pilot study is to investigate whether misconceptions exist in Australian students’ understanding of ozone depletion and the relationship to skin cancer in Australia. Students from year 3 through first year university were questioned about issues related to ozone depletion and skin cancer. A simple experiment is developed to examine whether some student concepts can be altered through the use of visual diagrams. Included in this paper is an update on the current status of ozone depletion over Australia, and the relati onship to UV radiation and skin cancer. In addition, a brief review of newspaper articles written about ozone depletion is conducted to explore what possible role the media plays in public misconceptions. Understanding the origin of students’ ideas can assist teachers in producing more effective study programs 1 and may be useful in developing a national strategy for teaching environmental issues. In Australia there is a particular interest in sun related issues because of the population’s high incidence of skin cancer. For example, in 1995 approximately 270,000 cases of nonmelanocytic skin cancer were diagnosed. This suggests that nearly two in three Australian residents will be treated for some non-melanocytic skin cancer during their lifetime. For the more life-threatening melanoma skin cancer, over 7,000 cases were diagnosed in Australia, with almost 1,000 fatalities reported. It is estimated that the cost of treating skin cancer in Australia is between $300-500 million per year. 2 In an attempt to improve the awareness of the dangers of sun related diseases, the government initiated a number of sun awareness campaigns to educate the public. These campaigns have been highly effective in getting across the message of the sun’s potential harm. In a survey by the Victorian Anti Cancer Council, almost 80% of respondents had heard the term ‘Sun Smart,’ and correctly understood what the phrase meant. 3 Student awareness of the sun and issues related to ozone depletion are also particularly strong. In a recent survey of high school students from Melbourne and Brisbane, the destruction of the ozone layer was identified as the most important environmental issue facing Australia and the

An Innovative Method of Increasing Early Detection for Skin Cancer in Australia

Abstract Objective: To evaluate a family practice intervention to encourage patients to request a skin examination during their consultation. Methods: Family physicians in Queensland, Australia, were randomized to intervention or control groups. In the intervention group, materials were provided by the office receptionist and supported by the family physician. Results: The rate of full-body skin examination was 99.3/ 1000 consultations in intervention-group practices compared to 22.4/ 1000 in control-group practices (p<0.05). Conclusion: This trial indicates that a program focussing on practice reception staff, as well as family physicians, can encourage the early detection of skin cancer.