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Data helps target skin cancer screening

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The latest Federal Government report into skin cancer mortality risk in Australia reveals not only what cohorts are most at risk, but what sort of cancer they are most susceptible to, depending on factors such as age, sex, location, ethnic background and socio-economic status.
 
By linking death rates and data from the 2016 and 2022 Censuses, the Australian Institute of Health and Welfare (AIHW) has revealed new insights into those most at risk of death from skin cancer, to better identify target populations for the nation’s next skin cancer screening program.
 
With $10.3 million in Federal funding, Melanoma Institute Australia is developing a Roadmap for Targeted Skin Cancer Screening Program, in collaboration with stakeholders including the AIHW, Cancer Australia, primary healthcare networks, states and territories and clinicians.
 
Australia has the highest rate of melanoma in the world, and the condition is the nation’s 10th most common cause of cancer deaths. However, non-melanoma skin cancer (NMSC) sits in the top 20 for most common cause, according to the AIHW.
 
In 2025, an estimated 2300 people died from skin cancer in Australia, with the death rate for melanoma twice as high as that for NMSC.
 
In its new study, the AIHW found higher death rates for both melanoma and NMSC among people with disability, people living in low socio-economic, rural or regional areas, and people with Oceanian and North-West European heritage.
 
Other key details include:
 

• melanoma death rates are higher among males than females, and increase with age
• Aboriginal and Torres Strait Islander people have lower melanoma death rates than non-Indigenous Australians, but similar NMSC death rates
• while death rates for both types of skin cancers increase with age, melanoma death rates start rising 10 years earlier – around 60–64 years of age compared with 70–74 years for NMSC.

 
Dr Tracey Purnell, RACGP Specific Interests Dermatology Chair, told newsGP that while she found ‘no surprises’ in the AIHW report, she believes the ‘really useful’ information can hopefully be used to target higher risk populations.
 
‘There’s no evidence that screening everybody in Australia is going to pick up more cancer,’ she said.
 
‘So that’s what they’re working on with that targeted skin cancer program.
 
‘A lot of doctors will tell you that the people who present for skin cancer checks are the “worried well” and not the high-risk groups.
 
‘As for the reason why blokes have a higher risk, they tend to be less health aware than women; there’s a lot of data to support that.’
 
Dr Purnell has seen first-hand during a visit to a nursing home patient how an at-risk person can slip through the screening cracks.
 
‘I remember pulling the sheet back and seeing a large squamous cell carcinoma on someone’s ankle,’ she said.
 
‘The nurses were just sort of putting a dressing over it, and they called it a chronic ulcer, but it was an actual cancer.
 
‘It was just an example of how things can maybe get missed easily in patients with disability, because this person was literally bed bound. It’s an example of misdiagnosis, or perhaps being busy caring for someone’s physical needs and overlooking their skin as not as a higher priority perhaps.’
 
Based in Wagga Wagga, Dr Purnell is pleased to see rural and regional areas identified in the report.
 
‘We have one dermatologist who doesn’t take new patients, so the burden of care is on GPs,’ she said.
 
However, she said with no Medicare item number for skin checks, combined with the present economic climate, many people who need the checks are missing out.
 
‘With current economic pressures from [fuel] prices, we’ve had some of our patients who come a couple of hours to see us postpone their appointments,’ she said.
 
‘Targeting those lower socio-economic groups, there would have to be provision of funding for doctors to be able to skin check those patients.
 
‘It’s the same for dermatologists – they don’t have a skin cancer item number [either]. They’re just using their normal attendance item numbers.
 
The final Roadmap report to the Australian Government is due in September 2028.
 
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