It’s a spot of bad news in an otherwise hopeful update on cancer in Canada.
Skin cancer, one of the most preventable forms of the disease, is also one of the fastest-rising in this country, according to a new report from the Canadian Cancer Society that notes the death rate for all cancers combined continues to fall for most age groups.
“Melanoma is certainly increasing more than nearly all other cancers,” said Frances Wright, the head of breast and melanoma surgery at Sunnybrook Health Sciences Centre in Toronto. “They [rates] are increasing rapidly and it’s probably related to behaviour, related to lack of sun protection.”
When it comes to malignant melanoma – the type of skin cancer that is likelier to spread and kill – the rate of new cases has climbed significantly over the past 25 years. So has the melanoma death rate. Only lung cancer deaths in women and liver cancer deaths in men have increased at a faster pace, according to Canadian Cancer Statistics 2014, the annual compendium of cancer figures and projections published by the Canadian Cancer Society, Statistics Canada and the Public Health Agency of Canada.
The report, released Wednesday, estimates 6,500 new cases of malignant melanoma will be diagnosed this year, with 1,050 expected to die from the disease.
Another 76,100 are expected to be diagnosed with less-serious non-melanoma skin cancers, which can generally be removed at a dermatologist’s office and very rarely kill.
Over all, the report projects 191,300 new cases of cancer will be diagnosed this year, excluding non-melanoma skin cancers. Cancer is expected to kill 76,600 people in 2014.
The Canadian Cancer Society decided to focus on skin cancer in this year’s report because it is one of the cancers that continues to defy a larger and more positive trend. Although cancer remains the top killer in Canada, the rate of new cases is stabilizing and death rates are falling. Survival rates are up, too.
(This is despite the fact that the actual number of people diagnosed with, and killed by, cancer is going up as Canada’s population gets older. Like most studies of cancer statistics, this one adjusts the rates to take into account the aging population.)
“There’s obviously some successes that we’ve had over the past 30 years,” said Prithwish De, an epidemiologist with the Canadian Cancer Society. “For example, the death rate for cancer has been declining since 1988 for both men and women. The five-year relative survival [rate] has increased to 63 per cent from 56 per cent over about a decade or so.”
But melanoma is a different story. For men, the incidence rate increased 2 per cent per year between 1986 and 2010, while the death rate rose 1.2 per cent a year. The corresponding figures for women are 1.5 per cent and 0.4 per cent per year.
More men than women contract skin cancer and die from it in large part because men have historically exposed more of their skin to the sun, Dr. Wright said. “You often see guys around with their shirts off. We often see it in people who’ve been outdoor workers. The more sun exposure you get, the more tanned you get, you’re more likely to get a skin cancer, essentially,” she said.
Malignant melanomas generally start as asymmetrically shaped moles that change colour and can be itchy. If caught early, at stage one, melanoma is highly treatable with surgery.
But it is disconcerting that skin cancer, a disease that can easily be prevented by wearing sunscreen, covering up, seeking shade and avoiding tanning beds, is still on the rise, said Loraine Marrett, a senior scientist at Cancer Care Ontario, the provincial agency that combats the disease.
“We ought to be seeing skin cancer rates fall, shouldn’t we?” she said. “But we don’t.”
In a bid to reverse that, the Canadian Cancer Society, Cancer Care Ontario and several other organizations are working on new sun safety guidelines they hope to release later this year or early next, Ms. Marrett said.