Skin cancer: Know your risk
Understanding your skin cancer risk factors can pay off
We love our Aussie summers, don’t we? There’s nothing quite like getting out in the sunshine and really making the most of the warmer months and what our country has to offer. But there’s a hidden danger lurking when we’re having fun outdoors, and that is the sun.
“Australia has the highest rates of skin cancer in the world mainly due to sun exposure and also due to large numbers of people in Australia with fair skin,” says Dr Hamish Black, nib group medical advisor.
“Solar damage is the major preventable cause of skin cancer. You can prevent this damage by following the SunSmart advice – slip on clothing, slop on sunscreen, slap on a hat, seek shade and slide on sunglasses.”
The good news is that simple measures like knowing your risk can help you catch skin cancer early. Take the nib skin self-assessment to get to know your skin better.
Information about skin cancer
Skin cancer occurs when skin cells grow abnormally. This is usually the result of too much exposure to the sun’s harsh ultraviolet (UV) rays. There are three main types of skin cancer: melanoma (the most dangerous), basal cell carcinoma (BCC), and squamous cell carcinoma (SCC).
What is melanoma?
Though melanoma accounts for only 1 to 2% of skin cancer cases, it's considered the most serious form as, once it has started growing, it can quickly spread to other parts of the body. If caught early, melanoma is often treatable. However, it can be fatal if it spreads. Often appearing as an existing spot, freckle or mole that changes colour, size or shape (or a new spot on the skin), melanomas are usually flat (though a mole increasing in height might be something to get checked out), with an irregular edge. If you see any changes in the spots on your body, visit your healthcare professional for a skin check.
What is basal cell carcinoma?
Basal cell carcinoma (BCC) is the most common form of skin cancer. It’s also the least dangerous, growing slowly over months or years (usually on the head, neck or upper body) and rarely spreading to other parts of the body. BCC may appear as a pearly spot or lump, a scaly, dry patch that may be shiny and pale or bright pink, or a sore that won’t heal or that bleeds (keep in mind, some BCC spots can be dark in colour). There are three types of BCC:
Superficial BCC, on the top layers of skin
Nodular BCC, which often looks like a rounded lump
Infiltrating BCC, the most difficult to see and often not detected until well advanced.
What is squamous cell carcinoma?
Squamous cell carcinoma (SCC) is another common form of skin cancer and, like BCC, not as dangerous as melanoma. However, left untreated, it can spread to other parts of the body and may prove fatal – so early detection is important. SCC is likely to grow over weeks or months, and may look like a crusted sore, a firm, red lump or a red, raised sore around the genitals or anus. It can also present as a sore patch of skin, a small ulcer or area of scaly, thickened skin on your lips, or a sore or rough patch inside your mouth.
What is Merkel cell carcinoma?
Merkel cell carcinoma, or MCC, is a type of skin cancer that develops in the ‘Merkel cells’ in the top layer of skin. While the highly aggressive MCC is quite rare, Australia has the highest incidence rates for this type of cancer in the world. It usually appears on sun-exposed skin as a painless, fast-growing pink/red or purple nodule. It's one of the most dangerous types of skin cancer because it’s more likely to spread to other parts of the body if it’s not caught early and can be difficult to treat when it’s spread.
What is solar keratosis?
Also known as actinic keratosis or sunspots, solar keratosis isn’t skin cancer per se, but squamous cell carcinomas can develop in these areas, so it’s important to keep an eye on them and have your doctor or health practitioner do the same. Commonly found in places that get a lot of sun exposure – for example, the bridge of the nose, the cheeks, upper lip and the backs of the hands – solar keratosis are spots of scaly, dry and inflamed skin.
Skin cancer statistics
Incidence & detection rate
Every year in Australia, skin cancers account for around 80% of all newly diagnosed cancers and most of these are caused by sun exposure. More than 11,500 Australians are diagnosed with melanoma each year and around 434,000 people are treated for non-melanoma skin cancers. In fact, Australia and New Zealand have the highest incidences of skin cancer in the world – meaning that many of us will either be affected by skin cancer or know someone who is.
Cost to the medical system
With such a high rate of skin cancer, there is a noticeable burden on the healthcare system, with an estimated annual cost upwards of $272 million for melanomas alone (and more than $1 billion for non-melanoma skin cancers).
Around 2,000 people die from skin cancer every year in Australia, and men are at higher risk than women of developing skin cancers. The risk of mortality is also higher for men, who make up 69% of skin cancer deaths in Australia.
While this sounds very grim, the good news is most skin cancers can be treated successfully if detected early – and most non-melanoma skin cancers don’t pose a serious health risk. In fact, Cancer Australia puts the melanoma five-year survival rate at 92%.
Skin cancer risk factors
While anyone can get skin cancer, there are certain factors that may put you at a higher risk of developing this type of cancer. To understand your risk factor, use the nib skin self-assessment. Some risk factors include:
"Fairer skin contains less melanin and melanin protects the skin from burning on exposure to the sun. In particular, Fitzpatrick skin type 1 is the highest risk and that typically includes blue eyes, red hair and freckles as well as fair skin."
Though anyone can develop skin cancer, melanoma is more common in older adults. Every extra decade of sun exposure increases your skin cancer risk.
You are at higher risk if you have been sunburnt many times.
Having many moles, particularly large, irregularly shaped and unevenly coloured moles, on your skin increases skin cancer risk.
If someone in your family has had skin cancer you are at a higher risk.
If you’ve previously had skin cancer, you have a higher risk of developing another.
Lack of sun protection
Those who spend a lot of time outdoors without sun protection are at a greater risk.
Those who actively tanned or used solariums/sunbeds are at a higher risk of skin cancer.
Skin cancer prevention
There’s no question that skin cancer can be serious, but there are many steps you can take to both reduce your risk of developing skin cancer and increase your chances of early detection. Take the nib skin self-assessment and really get to know your own skin with regular DIY skin checks, so you are aware of any changes or abnormalities. If you fall into the high-risk category, speak to your doctor or healthcare professional about regular professional checks.
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Dr Hamish Black
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Dr Hamish Black
Dr Hamish Black has been a medical practitioner for more than 25 years. In addition to his role as nib group medical advisor, he still spends two days a week practising as a GP. He has spent many years working in emergency departments and in rural Australia, including a stint with the Royal Flying Doctor Service. Hamish also loves karaoke and dancing (though not that well at either, he says!), with Play that Funky Music by Wild Cherry being his karaoke favourite.