The Changing Incidence and Mortality of Melanoma in Australia
For many years Australia has had the highest incidence and mortality rates in the world for melanoma. The incidence rate has been increasing at around 5% per year and the mortality rate, at a rate slightly lower than that. Epidemiology studies have shown clearly that there is both a constitutional and an environmental contribution to melanoma risk, with sunlight being the major risk factor in the environment. The data also clearly show that the thickness of a melanoma at the time it is removed is one of the major determinants of the likelihood of metastasis and thus of the long-term prognosis. Both of these components have been incorporated into major public health programmes aimed at melanoma control in Australia over the last 25 years. Primary prevention programmes have been aimed at reducing the desire for a tan and subsequent overexposure to sunlight. Secondary prevention (early detection) programmes have encouraged people in the community to seek early attention if they notice a new or changing pigmented lesion. Although the age-adjusted incidence and mortality rates for Australia continue to rise, cohort analysis of both incidence and mortality rates reveals that the overall rise is not reflected in all age groups. In the younger cohorts - groups that it has been possible to influence by our public health campaigns in recent decades - both incidence and mortality rates are dropping.
Unable to display preview. Download preview PDF.
- Armstrong B, Kricker A (1994) Cutaneous melanoma. Cancer Surv Trends Cancer Incidence 19:219–239.Google Scholar
- Balch CM, Soong SJ, Shaw HM et al. (1985) An analysis of prognostic factors in 4000 patients with cutaneous melanoma. In: Balch CM, Milton GW (eds) Cutaneous melanoma: clinical management and treatment results worldwide. Lippincott, Philadelphia, pp 321–352.Google Scholar
- Evans RD, Kopf AW, Lew RA et al. (1988) Risk factors for the development of malignant melanoma. I. Reviews of case-control studies. J Dermatol Surg Oncol 14:393–406.Google Scholar
- Giles G, Thursfield V (1996) Trends in skin cancer in Australia. Cancer Forum 20:188–191.Google Scholar
- Giles G, Dwyer T, Coates M et al. (1989) Trends in skin cancer in Australia: an overview of the available data. Trans Menzies Found 15:143–147.Google Scholar
- Harper J (1998) Genetics and genodermatoses. In: Champion H, Burton JL, Burns DA, Breathnach SM (eds) Textbook of dermatology, 6th edn. Blackwell Scientific Publications, Oxford, pp 407–412.Google Scholar
- Jelfs P, Coates M, Giles GG et al. (1996) Cancer in Australia, 1989–1990 (with projections to 1995). Aust Institute Health Welfare, Canberra, p 147 Marks R (1996) Prevention and control of melanoma: the public health approach. CA Cancer J Clin 46:199–216.Google Scholar
- McGovern VJ (1952) Melanoblastoma Med J Aust I [Suppl 10]:139–143.Google Scholar
- Noy S, Houston J (1986) National Skin Cancer Awareness Week 1985: a new initiative in public education about skin cancer Cancer Forum 10:88–91.Google Scholar
- Parkin DM, Muir CS, Whelan SL et al. (1992) Cancer incidence in five continents, vol 6. (I ARC scientific publications 120) I ARC, Lyon.Google Scholar