Skin cancer is defined as an uncontrolled growth of abnormal cells within the skin. It is a
leading population health concern within Australia and is the fourth most frequently
diagnosed and costly cancers within Australia. It is projected that 2-3 Australians
are diagnosed with a form of skin cancer by the age of 70. In 2012, Australia had the
world’s second highest prevalence rate of melanoma, at 35 new cases a year per
100,000 people, this was more than 11 times as high as the estimated worldwide
Types of Skin Cancer
The skin, the largest organ, comprises of three cell types; basal cells, which make up
the lower layers of the skin, squamous cells, which construct the top layers of the
skin, and melanocytes, which generate the pigment of the skin.
Non-Melanoma Skin Cancer (NMSC)
Non-Melanoma Skin Cancer (NMSC) is any skin cancer which does not initiate from
melanocytes, the two most common forms of NMSC are Basal Cell Carcinomas
(BCC), and Squamous Cell Carcinomas (SCC). BCC’s account for roughly two thirds
of NMSC, whilst SCC’s are responsible for most other NMSC.
Basal Cell Carcinomas (BCC)
BCC’s inaugurate at the base of the skin cells, within the basal cells and are
distinguished for their development on areas of skin that have more exposure to
ultraviolet (UV) radiation, such as the face, neck and arms. BCC’s characteristically
grow gradually and slowly, and typically do not spread to other parts of the body.
Evidence suggests BCC’s are moderately easy to treat if they are small, however,
the chance of an individual being diagnosed a second time rises with the size of the
Squamous Cell Carcinomas (SCC)
SCC’s derive in the upper most skin cells, the squamous cells, and symptomatically
grow somewhat rapidly and can spread to other body areas.
Melanoma Skin Cancer
Melanoma Skin Cancer’s originate from the melanocytes and emerge on the skin as
a new lesion or an irregular spot that alters in colour. Melanoma skin cancers are the
most aggressive skin tumours and are capable of rapid growth and due to their
predisposition to metastasise. They are the most deadly form of skin cancer.
Research has discovered males are more prone to developing melanoma skin
cancers and this is often credited to their increased exposure to UV radiation from
the sun, hypothetically due to their outdoor occupations and their greater
participation in outdoor sporting activities.
What is the risk?
Skin cancer is typically an avoidable disease and is largely a consequence of over
exposure to UV radiation, most frequently from the sun. Considerable evidence indicates
UV radiation from the sun can directly damage our DNA, eventually leading to the
advancement of skin cancer. Occurrences of severe sunburn and recurrent UV
exposure over a lifespan surges the risk of skin cancer development.
Evidence also indicates that those with one or more first degree relatives with a
history of melanomas are at a vaster risk of being diagnosed with melanoma, and
that those with a family history of melanoma are more liable in fostering superficial
spreading melanomas. Those with a family history of NMSC could also have a
substantial risk of developing NMSC.
Individuals with fair skin lack melanin, which protects our skin from the sun’s UV
rays, as a result they are often more vulnerable to skin cancer development, whilst
those with darker skin are often linked to skin cancer mortality and morbidity, owing
to the often late skin cancer detection and diagnosis and more deeply invasive
Evidence has indicated there to also be a strong connection between the number of
benign naevi (moles) on a person’s body and the risk of diagnosis of melanoma, with
the vaster number of benign moles, the greater the chance of skin cancer diagnosis.
Skin protection and preventing skin cancer development
When spotted and treated early, skin cancers are often treatable and curable, which is why evidence endorses the following:
1. Routine self-skin examinations – these are recommended to be performed monthly, and if “in doubt, check it out”
2. Evidence advises to be aware of the following: — A growth which escalates in size and presents as pearly, transparent, tan, brown, black or multicoloured — A mole, birthmark or brown spot that increases in size, thickness and alters in colour or texture — A spot or sore that lingers and continues to itch, hurt, crust, scab or bleed — An open sore which does not heal within 3 weeks
3. Routine annual professional skin examination 4. And if you have a personal history of melanoma, routine mole maps and professional skin checks are a must
Additionally, The Skin Cancer Foundation (2019) recommends the following to
guarantee skin protection all year round:
Seek shade, particularly between the hours of 10am and 4pm
Avoid tanning and UV tanning beds
Cover up with clothing, and UV-blocking sunglasses
Use broad spectrum (UVA/UVB) sunscreen with an SPF of 15+ or more daily, all year round.
For prolonged outdoor activity, a water resistant, broad spectrum (UVA/UVB) sunscreen with an SPF of 30+ or higher is required
Apply 2 tablespoons of sunscreen to your entire body 30 minutes prior being outdoors, and apply every two hours post swimming or excessive sweating
Newborns should be kept out of the sun at all times, and sunscreen can be applied to babies once they are over the age of 6 months
The role of the Dermal Clinician
The Dermal Clinician performs a significant role in the screening and early detection
of skin cancer through the application and employment of a dermatoscope.
Dermoscopy, also dubbed dermatoscopy, is a non-invasive diagnostic method that is
implemented using a handheld instrument called a dermatoscope. This device has a
transilluminating light source and standard magnifying optics (10X) which allows
swift assessment and enables imaging of subsurface skin structures located within
the epidermis, dermo-epidermal junction and the papillary dermis, which are
otherwise undetectable to the naked eye. Evidence states Dermoscopy
considerably improves diagnostic precision and specificity for skin cancer
Advancements in research
While UV sun exposure is the main root for skin cancer development, there are also
other exogenous exposures which may be causative of its progression, and research
maintains there is an urgent need for further research in order to overcome the skin
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Marghoob, A. A., Usatine, R. P., & Jaimes, N. (2013). Dermoscopy for the family physician. American Family Physician, 88(7), 441–450. Retrieved from https://search-ebscohost-com.wallaby.vu.edu.au:4433/login.aspxdirect=true&db=mnh&AN=2413408&site=eds-live
Ratushny, V., Gober, M. D., Hick, R., Ridky, T. W., & Seykora, J. T. (2012). From keratinocyte to cancer: the pathogenesis and modeling of cutaneous squamous cell carcinoma. The Journal Of Clinical Investigation, 122(2), 464–472. https://doi-org.wallaby.vu.edu.au:4433/10.1172/JCI57415
Shih, S. T. F., Carter, R., Heward, S., & Sinclair, C. (2017). Skin cancer has a large impact on our public hospitals but prevention programs continue to demonstrate strong economic credentials. Australian And New Zealand Journal Of Public Health, 41(4), 371–376. https://doi-org.wallaby.vu.edu.au:4433/10.1111/1753-6405.12679
Šitum, M. ( 1,3 ), Buljan, M. ( 1,3 ), Kolić, M. ( 1 ), & Vučić, M. ( 2,4 ). (n.d.). Melanoma - Clinical, dermatoscopical, and histopathological morphological characteristics. Acta Dermatovenerologica Croatica, 22(1), 1–12. Retrieved from https://search-ebscohost-com.wallaby.vu.edu.au:4433/login.aspx?direct=true&db=edselc&AN=edselc.2-52.0-84900800760&site=eds-live
Skin Cancer Foundation. (2019). Retrieved from https://www.skincancer.org/
Skin cancer in Australia. (2019). Retrieved from https://www.aihw.gov.au/reports/cancer/skin-cancer-in-australia/contents/table-of-contents
Teresa Russo, Vincenzo Piccolo, Aimilios Lallas, & Giuseppe Argenziano. (2016). Recent advances in dermoscopy [version 1; referees: 2 approved]. F1000 Research. https://doi-org.wallaby.vu.edu.au:4433/10.12688/f1000research.7597.1
Whiteman, D. C., Neale, R. E., Aitken, J., Gordon, L., Green, A. C., Janda, M., …Soyer, H. P. (2019). When to apply sunscreen: a consensus statement for Australia and New Zealand. Australian And New Zealand Journal Of Public Health, 43(2), 171–175. https://doi-org.wallaby.vu.edu.au:4433/10.1111/1753-6405.12873