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Melanoma has been replaced as the deadliest form of skin cancer

New research unveiled at the European Academy of Dermatology and Venerology (EADV) Congress 2023 has brought forth a surprising revelation. Non-melanoma skin cancer (NMSC) is now responsible for a higher number of global deaths compared to melanoma, despite melanoma being regarded as the more severe form of skin cancer.

The data, collected from the World Health Organization International Agency for Research on Cancer, further implies that the true impact of NMSC might be even graver than previously thought, as the condition often goes underreported.

More cases equals more deaths

Professor Thierry Passeron, who spearheaded the research, shared, “Although NMSC is less likely to be fatal than melanoma skin cancer, its prevalence is strikingly higher. In 2020, NMSC accounted for 78% of all skin cancer cases, resulting in over 63,700 deaths. In contrast, melanoma caused an estimated 57,000 fatalities in the same year.”

This illustrates that despite the lesser individual fatality rate of NMSC compared to melanoma, the sheer number of NMSC cases contributes to a greater overall death toll.

Delving deeper into the figures, Professor Passeron cautioned that these numbers might only be the tip of the iceberg. “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.”

Skin cancer demographics

In their comprehensive study, the researchers also pinpointed specific demographics that appeared more vulnerable to NMSC. These include outdoor workers exposed to the sun for prolonged periods, organ transplant recipients, and individuals diagnosed with xeroderma pigmentosum—a genetic disorder characterized by extreme sensitivity to sunlight.

Skin cancer’s reach is not limited by geographical or ethnic boundaries. While a significant incidence was found among fair-skinned and elderly populations in countries like the USA, Germany, UK, France, Australia, and Italy, countries with a predominantly darker-skinned populace are not spared. Evidence for this is the 11,281 recorded skin cancer deaths in Africa.

Non-melanoma skin cancer (NMSC)

In 2020 alone, a staggering 1.2 million cases of NMSC were reported globally, in contrast to the 324,635 cases of melanoma. It’s important to highlight that most skin cancer diagnoses are non-melanoma.

These cancers typically manifest in the skin’s upper layers and are broadly categorized into types such as basal cell carcinoma and squamous cell carcinoma. Compared to melanoma — which originates in melanocytes, the pigment-producing cells — NMSC is less aggressive, as it is less likely to metastasize to other body parts and can often be treated more effectively.

More effective messaging needed

Professor Passeron comments, “We have to get the message out that not only melanoma can be fatal, but NMSC also. 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.”

“Our study did not find consistent evidence to suggest that having more dermatologists per capita could reduce mortality rates. Surprisingly, countries like Australia, the UK and Canada, with fewer dermatologists, exhibited low mortality-to-incidence ratios. We therefore need to explore what strategies these countries are employing to reduce the impact of skin cancer in further depth. The involvement of other healthcare practitioners, such as GPs, in the identification and management of this disease may partly explain their success. There remains huge opportunity worldwide to elevate the role of GPs and other healthcare professionals in this process and train them to recognise suspicious lesions early.”

Skin cancers are preventable

“In alignment with this, there is an ongoing need to develop awareness campaigns that educate the general public about the risks of sun exposure and other relevant risk factors. These campaigns should be tailored to at-risk populations, including those with fair skin, outdoor workers, the elderly and individuals who are immunosuppressed. Importantly, these efforts should also extend to populations that may not typically be considered at high risk, such as darker-skinned populations.”

Professor Passeron concludes, “Skin cancers are preventable and treatable, so we need to do more to ensure we are stopping the progression of this disease as early as possible to save lives.”

In light of these findings, it is crucial for global health organizations and governments to recognize the extensive reach and impact of NMSC, ensuring that preventative measures, accurate reporting, and effective treatments are prioritized.

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