Non - melanoma cancer

Non-melanoma skin cancers are the most common cancers in Australia, however most are not life-threatening.

The two main types are basal cell carcinoma and squamous cell carcinoma. A third group of lesions called keratinocyte dysplasias includes solar keratosis, Bowenoid keratosis and squamous cell carcinoma in-situ (Bowen’s disease). These are not invasive cancers, however may require treatment as some may develop into non-melanoma skin cancers.

Incidence and mortality

In 2008, an estimated 434,000 Australians were treated for non-melanoma skin cancers.

In 2011 in Australia, there were 543 deaths non-melanoma skin cancer.

Screening

There is no organised screening program for skin cancer. People should be aware of their skin and see a doctor if there are any significant changes, such as changes in shape, colour or size of a pigmented lesion or a new lesion.

Symptoms and diagnosis

Symptoms of non-melanoma skin cancers include:

any crusty, non-healing sores
small lumps that are red, pale or pearly in colour
new spots, freckles or any moles changing in colour, thickness or shape over a period of weeks to months (especially those dark brown to black, red or blue-black in colour).

Diagnosis is by biopsy (removal of a small sample of tissue for examination under a microscope).

Staging

Usually a biopsy is sufficient to determine the stage of a non-melanoma skin cancer. In cases of squamous cell carcinoma, lymph nodes may be examined to see if the cancer has spread. The staging system used is the TNM system, which describes the stage of the cancer from stage I to stage IV.

Causes

Skin cancer occurs when skin cells are damaged, for example, by overexposure to ultraviolet (UV) radiation from the sun. Between 95% and 99% of skin cancers in Australia are caused by exposure to the sun. The risk of skin cancer is increased for people who have:

increased numbers of unusual moles (dysplastic naevi)
fair skin, a tendency to burn rather than tan, freckles, light eye colour, light or red hair colour
had a previous skin cancer.

Prevention

Avoid sunburn by minimising sun exposure when the SunSmart UV Alert exceeds 3 and especially in the middle of the day when UV levels are most intense. Seek shade, wear a hat that covers the head, neck and ears, wear sun protective clothing and close-fitting sunglasses, and wear an SPF30+ sunscreen. Avoid using solariums (tanning salons).

Treatment

Non-melanoma skin cancers are almost always removed. In more advanced skin cancers, some of the surrounding tissue may also be removed to make sure that all of the cancerous cells have been taken.

Most common skin cancers (basal and squamous cell carcinomas) can be treated with ointments or radiation therapy. They can also be removed with surgery (usually under a local anaesthetic), cryotherapy (using liquid nitrogen to rapidly freeze the cancer off), curettage (scraping) or cautery (burning).

Prognosis

An individual's prognosis depends on the type and stage of cancer, as well as their age and general health at the time of diagnosis. The majority of non-melanoma skin cancers are successfully treated

For more information, contact Cancer Council Helpline on 13 11 20 (cost of a local call).

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For more information

Sources

Australian Institute of Health and Welfare (AIHW) 2012. ACIM (Australian Cancer Incidence and Mortality) Books. AIHW: Canberra.
Australian Institute of Health and Welfare & Cancer Australia 2008. Non-melanoma skin cancer: general practice consultations, hospitalisation and mortality. Cancer series no. 43. Cat. no. 39. Canberra: AIHW.
Australian Bureau of Statistics. Causes of death 2011. 3303.0. Commonwealth of Australia:Canberra, Australia 2012

This page was last updated on: Tuesday, March 19, 2013