Rising skin cancer rates are more likely to affect wealthy people, says 12-year review

Skin cancer levels have shown a significant increase in Northern Ireland since the early 1990s and are more likely to affect men, older people and those living in more affluent areas, according to a study just published in the June issue of British Journal of Dermatology.

Researchers who looked at official cancer statistics for nearly 23,000 patients over a 12-year period, reported a 20 per cent increase in patients and a 62 per cent increase in skin cancer samples processed by pathology laboratories.

The figures also showed that the three most common skin cancers - basal cell carcinoma, squamous cell carcinoma and malignant melanoma - accounted for 27 per cent of all male cancers and 26 per cent of all female cancers.

“These findings show that many patients will have more than one skin cancer, highlighting the need to analyse both patient numbers and sample numbers to provide an accurate picture of cancer levels” says co-author Dr Susannah Hoey from the Dermatology Department at the Royal Victoria Hospital, part of the Belfast Health and Social Care Trust.

“The three skin cancers we looked at all increased with age, with the exception of malignant melanomas, which showed a decrease in men aged 75 and over.

“And there was a link between more patients living in wealthier areas and increased levels of malignant melanomas and basal cell carcinomas.”

The team looked at data collected by the Northern Ireland Cancer Registry, at Queen’s University Belfast, from 1993 to 2004, analysing the records of patients diagnosed with the three most common skin cancers.

They found that men were 30 per cent more likely to suffer from basal cell carcinoma, the most common form of skin cancer, which affected some 1,444 people a year in Northern Ireland during the study period and accounted for 17 per cent of all reported cancers.

And men were twice as likely to suffer from squamous cell carcinoma than women, accounting for 357 of the 640 cases reported each year.

Women were, however, 30 per cent more likely than men to suffer from malignant melanoma - the least common, but most serious skin cancer - which averages 186 cases a year.

Being well-off was a disadvantage when it came to skin cancer.

Women living in affluent areas were 29 per cent more likely than people living in disadvantaged areas to suffer from basal cell carcinoma and nearly two and a half times more likely to suffer from malignant melanoma.

Men displayed a similar pattern. They were 41 per cent more likely to suffer from basal cell carcinoma if they lived in an affluent area and two and a half times more likely to suffer from malignant melanoma.

Affluence didn’t, however, seem to affect squamous cell carcinoma.

Malignant melanomas showed the greatest increase over the 12-year study period, with a 48 per cent rise in patients and a 71 per cent rise in samples. Squamous cell caricoma patients rose by 28 per cent, with a 57 per cent rise in samples, and basal cell carcinoma patients rose by 13 per cent, with a 62 per cent rise in samples.

“The majority of the people who live in Northern Ireland have fair skin and the 2001 census revealed that less than one per cent of the population belongs to a black or minority ethnic group” adds co-author Dr Olivia Dolan, consultant dermatologist at the Royal Victoria Hospital.

“This means that our results are less likely to be affected by different skin tones and ethnic origin than research carried out in countries with a greater ethnic mix.”

The authors point out that the general increase in incidences of skin cancer, coupled with ageing populations, will place greater demands on dermatology and other related specialties over the coming years.

“The number of people aged 60 and over is set to rise by more than a half by 2030 and 80 per cent of all skin cancers occur in this age group” says Dr Dolan.

“It is important that we plan ahead so that we are able to care for patients with skin cancer without compromising other chronic dermatological diseases.”

The authors – from the Dermatology Department at the Royal Victoria Hospital and Queen’s University Belfast - say that their research reinforces the need for anyone exposed to the sun to take sensible precautions, whether they are at home or on holiday.

“Although our research highlights that some section of society face greater risks than others, the safe sun message is one that we all need to heed if we are to halt rising skin cancer rates” concludes Dr Hoey.

• Skin cancer trends in Northern Ireland and consequences for provision of dermatology services. Hoey et al. British Journal of Dermatology. 156, pp1301-1307. June 2007.

• British Journal of Dermatology is published monthly on behalf of the British Association of Dermatologists by Blackwell Publishing Ltd. Edited by Dr John English, the journal publishes peer-reviewed papers on both clinical and experimental research in dermatology. www.blackwellpublishing.com/bjd

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