What is skin cancer?
Skin cancers are very common, accounting for more than a fifth of all cancers in England. There are two main groups of skin cancer: malignant melanoma and non-melanoma skin cancer. The majority of skin cancers are non-melanoma skin cancers even though experts have said that not all cases are registered (South West Public Health Group, 2010). These skin cancers are more common in men than women and rarely spread to other parts of the body. Malignant melanomas account for about 12% of skins cancers and while they may remain localised, they may also spread through the blood or lymph system to other organs. Here we focus on malignant melanomas.
Where in England are skin cancer rates highest?
Over the last ten years, rates of newly diagnosed malignant melanoma skin cancer were highest in the South West and the South East regions of England. In 2011, rates were 24.1 per 100,000 men in the South West and 21.4 per 100,000 men in the South East. In the same year, the rate was 23.0 per 100,000 women in the South West and 20.4 per 100,000 women in the South East. Rates were lowest in London: 11.7 new cases per 100,000 men in 2011 and 10.0 new cases per 100,000 women (ONS, 2013).
Figure 1: Malignant melanoma skin cancer across England, 2002-2011: Men
Figure 2: Malignant melanoma skin cancer across England, 2002-2011: Women
Sun exposure and age in part explain the regional differences. The South West has been shown to be one of the sunniest parts of the UK and about a quarter of its population is beyond retirement age (Poirier et al, 2008). Ethnicity is another factor which explains regional differences in rates of skin cancer. Areas where a larger proportion of the population is white are associated with higher rates of malignant melanoma skin cancer (Hounsome et al, 2009).
Do skin cancer rates vary between men and women?
Forty years ago, malignant melanoma skin cancer was more common in women than men: 3.1 newly diagnosed cases per 100,000 women compared with 1.7 newly diagnosed cases per 100,000 men in 1971. These rates have increased considerably and more so for men. In 2011, there were 17.4 newly diagnosed skin cancers per 100,000 women compared with 17.1 per 100,000 men. A number of factors may explain the increase in skin cancer, including a national rise in affluence and an increase in foreign travel (Hounsome et al, 2009).
In 1971, more women than men died of malignant melanoma skin cancer: 1.3 deaths per 100,000 women compared with 1.0 deaths per 100,000 men. In 2011, more men than women died of this type of skin cancer: 3.3 deaths per 100,000 men compared with 2.0 deaths per 100,000 women.
Survival of malignant melanoma skin cancer is very high for both men and women: for those diagnosed between 2006 and 2010, 91% of women and 84% of men survived for at least five years (ONS, 2012).
For men, the most common area of the body for malignant melanoma skin cancer is the trunk (chest and back) while for women it is the legs (National Cancer Intelligence Network, 2012). The main risk factors are the same for men and women: a history of sunburn (especially blistering sunburn), having a large number of moles or having fair skin, freckles, red or blond hair and blue or pale eyes (National Cancer Intelligence Network, 2012).
Hounsome L, Poirier V, Dancox M, Ives A, Harris S, Verne J. (2009) “Analysis of the Increase in Incidence of Malignant Melanoma, and Correlations with External Factors”. South West Public Health Group.
National Cancer Intelligence Network (2012) “Understanding cancer: oncology training for NHS and Public Health non-clinical staff”.
Office for National Statistics (2013) Cancer Statistics Registrations, England (Series MB1), No. 42, 2011 .
Office for National Statistics (2012) Cancer Survival Rates - Cancer Survival in England: Patients Diagnosed, 2006–2010 and Followed up to 2011.
Poirier V, de Berker D, McPhail S, Verne J. (2008) “Skin cancer: addressing the needs of the South West”. South West Public Health Group.
South West Public Health Group (2010) Non-Melanoma Skin Cancer: Estimates of cases, November 2010.
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