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Time to scale-up prevention over detection of skin cancers

Investing in the promotion of daily sunscreen use and other sun protection strategies in Australia would save more than 50,000 lives and millions more dollars than screening for skin cancers over a 30-year period, a new QIMR Berghofer study has found.

The study also found there would be 270,000 fewer melanoma diagnoses and four million fewer of the common skin cancers squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) with more consistent sunscreen use over that time-frame.

The researchers used data from Queenslanders who were regularly checked for skin cancers, people who used sunscreen daily, and people who did neither, to predict the economic cost, the number of melanoma-related deaths, and the number of melanomas, SCCs and BCCs associated with each behaviour.

Lead researcher and head of QIMR Berghofer’s Health Economics Research Group, Associate Professor Louisa Gordon, said the results were compelling.

“Daily sunscreen use across the entire population, compared to early detection, will prevent substantially more new skin tumours and melanoma deaths while also saving healthcare costs,” Associate Professor Gordon said.

“Our study found about 215 more lives per 100,000 people would be saved through daily sunscreen use, compared to relying on whole-body skin examinations by doctors.

“However, screening would save about 11 lives per 100,000 people compared to doing nothing.

“It would also save about $216 million dollars for the health care system.”

Associate Professor Gordon said while screening would always play an important role in skin cancer management, the focus needed to shift considerably to prevention.

“These results confirm that health authorities need to prioritise investment in primary prevention campaigns that promote daily use of sunscreen if they want to reduce skin cancer cases and deaths around the world,” she said.

“Estimating the health and economic value of early melanoma detection versus melanoma prevention is critical for decision-makers who are grappling with constrained health budgets, yet it appears the two strategies have never been compared before.”

Melanoma is a major public health burden in many fair-skinned populations. It is the most serious type of skin cancer and can be fatal if diagnosed at an advanced stage.

More than 60,000 people die globally each year from melanoma, with one quarter of those (around 15,500) deaths occurring in the US, the UK and Australasia.

About 2000 people die from melanoma in Australia each year.

The study was based on the mainly fair-skinned population of the Australian state of Queensland who experience high UV radiation levels year-round.

The male and female participants had a mean age of 50 and were tracked through yearly cycles. Their data was then modelled to estimate what their risk of skin cancers would be if they used sunscreen, got skin checks or continued the status quo.

The study has been published in the journal BMJ Open.

The research was funded by QIMR Berghofer.

Quick Facts:

More than 2,000 Australians die from melanoma each year and almost 600 die from squamous cell carcinoma of the skin.

Each year, more than 400,000 Australians develop at least one SCC or BCC, resulting in more than 750,000 Medicare claims.

SCCs and BCCs cause considerable death and illness; each year in Australia they account for nearly 600 deaths and 109,000 hospital admissions (more than twice the number of admissions for each of bowel, breast or prostate cancers).

All forms of skin cancer are estimated to cost the Australian health care system more than $1 billion dollars.

In England, it is estimated that £180 million will be spent by the NHS on skin cancer by 2020.

In the US, the annual economic burden of treating melanoma, SCCs and BCCs is US$8.1 billion, and is increasing each year.

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