Melanoma ‘no longer the leading cause of skin cancer deaths’

Researchers fear ‘alarming figures’ may be underestimated

Melanoma is no longer the most common cause of skin cancer deaths, a new study has found.

Researchers said non-melanoma skin cancers (NMSC), typically thought to be less serious, are causing more deaths across the globe.

They also believe NMSC is underreported and that the true impact of the disease may be higher than previously thought.

Skin cancer is one of the most common types of the disease globally. There are two types: NMSC refers to the more common group that slowly develops in the upper layers of the skin. Melanoma, meanwhile, is a type of skin cancer that can spread to other areas of the body.

The main cause of both is exposure to ultraviolet rays, which come from the sun and are used in tanning beds. Professor Thierry Passeron, lead author of the study and dermatologist at Nice University Hospital, said that the “strikingly higher” prevalence of NMSC had pushed deaths up.

A new mole or a change in an existing mole may be signs of melanoma, while NMSC usually appears as a lump or discoloured patch on the skin that persists after a few weeks and slowly progresses over months or sometimes years.

“In 2020, NMSC accounted for 78 per cent of all skin cancer cases, resulting in over 63,700 deaths,” he said. “In contrast, melanoma caused an estimated 57,000 fatalities in the same year. The significantly higher incidence of NMSC has, therefore, led to a more substantial overall impact.”

He added: “As alarming as these figures are, they may, in fact, be underestimated. NMSC is often underreported in cancer registries, making it challenging to understand the true burden.”

NHS example of what NMSC might look like (NHS)

An example of what melanoma could look like (NHS)

For their study, researchers looked at data from the World Health Organisation International Agency for Research on Cancer.

In 2020, there were nearly 1.2 million reported cases of NMSC worldwide compared with 324,635 cases of melanoma. “We have to get the message out that not only melanoma can be fatal, but NMSC also,” professor Passeron said.

“It’s crucial to note that individuals with melanin rich skin are also at risk and are dying from skin cancer. There is a need to implement effective strategies to reduce the fatalities associated with all kinds of skin cancers.”

The study did not find any evidence that having more dermatologists per capital could reduce cancer mortality rates.

File photo: A doctor examines a mole

Countries such as Australia, the UK and Canada, which had fewer dermatologists, exhibited low mortality-to-incidence ratios, the study, presented to the European Academy of Dermatology and Venerology Congress 2023 found.

The involvement of other healthcare practitioners, such as GPs, in the identification and management of this disease may partly explain their success, it added.

There remains a huge opportunity worldwide to elevate the role of GPs and other healthcare professionals in this process and train them to recognise suspicious lesions early, the study said.

In the UK, around 147,000 new cases of non-melanoma skin cancer are diagnosed each year, the NHS says.

The disease affects more men than women and is more common in the elderly.

Between 2016 and 2018 there was an average of 16,755 new cases of melanoma diagnosed in the UK, according to Cancer Research UK.