Older men at higher risk of skin cancer: sun safety campaigns too youth-focused


A study that was presented at the World Congress on Cancers of the Skin in Edinburgh Scotland, reveals melanoma skin cancer rates in England to be rising faster in older men than any other demographic, suggesting that awareness campaigns might be too youth-focussed.

Conducted by analysts at Public Health England (PHE), the research discovered that the incidence rate of melanoma, the most serious form of skin cancer, is rapidly increasing in the older population, in particular amongst men, raising concerns that current sun safety campaigns are not reaching these groups.

The most common type of melanoma – called superficial spreading melanoma – increased by 12 per cent per year over a 21-year period (1990 to 2010) for men aged 60 and over, surpassing the incidence rates for older women (nine per cent) and younger men (eight per cent). The increase in thicker (more advanced) tumours in older men is also increasing at a greater rate than in other demographics – a 12 per cent increase per year compared to just six per cent in younger men -  suggesting that older men may be seeking medical advice later.

Melanoma is more common on the back in men and it is difficult for patients to spot early changes in a lesion on the back. Furthermore, in older people it is common to develop a variety of harmless lesions on the skin, such as warts. Differentiating melanomas from these is difficult. These two observations may contribute to older men presenting with thicker tumours.

The increase in melanoma incidence rate for older men varied by body site, with the fastest rise on the trunk and upper limbs (both around nine per cent per year), whilst for other demographic groups there was no such variation.

PHE’s findings are mirrored by an earlier study into skin cancer incidence rates in the Scottish population*, which showed rates of melanoma trebling in males between 1979 and 2003 (with 206 cases between 1979 and 1983, and 2073 from 1999 to 2003) and the greatest increases being seen in those aged 60 and over.

Julia Verne, Director of the South West Knowledge and Intelligence Team, Public Health England commented: “Studies into the causes of melanoma have emphasised the importance of excessive UV exposure and especially burning through recreational activities and holidays. The findings of this study highlight the need for education campaigns to target the entire spectrum of people across all demographics about the dangers of sunburn and sunbathing.”

Johnathon Major of the British Association of Dermatologists added: “Older men have continuously proved a problematic group for us to target with skin cancer advice and studies such as these underline the requirement to reach them. We are constantly developing our communication initiatives to tender to wider audiences and target groups such as these who have been demonstrated to be in particular need. With health messaging, there can be an over-reliance on newer technologies such as social media, but these don’t always reach the groups most in need. 

“For this reason we now operate two major sun awareness campaigns each year - Sun Awareness Week and the Be Sun Aware Roadshow, both of which are aimed at all age groups. We try to visit a range of outdoors events, from sporting events to gardening shows, to capture people whose recreational activities mean they spend time in the sun, perhaps unprotected.

“There are two issues at play here – skin cancer rates are rising faster in this group, so we conclude that protecting the skin from sun damage is important for adult men as well as others, and second, there is concern that older men also seem to be presenting later. This shows we need to address both our prevention messages, and our early detection messages, at older people as a matter of priority. ”

Ends-

 

Notes to editors:

For more information please contact: Matt Gass, Communications Officer, on 020 7391 6084 or at matthew.gass@bad.org.uk

If using this study, please ensure you mention that the study was released at the World Congress on Cancers of the Skin.  

The conference will be held in Edinburgh from September 3rd to 6th 2014, and is attended by approximately 1,000 UK and worldwide health professionals.

The World Congress on Cancers of the Skin 2014 was founded by The Skin Cancer Foundation, the international organization devoted solely to education, prevention, early detection, and prompt treatment of the world’s most common cancer. It is organised by the British Association of Dermatologists.

 

Study details:

Cutaneous melanoma in older persons, V.Poirier, T.Jones, A.Ives, J. Newton-Bishop and J.Verne

Background

Previous reports from the UK highlighted a higher incidence of melanoma in women. However, we recently reported a considerable and remarkable change in melanoma incidence with the most rapid increase occurring in older people and especially men. We consider here whether this reflects an emerging pattern indicative of a proportion of tumours with a different aetiological route to melanoma.

Methodology

We examined melanoma (ICD-10 C43) incidence trends (1990-2010) in England using the National Cancer Data Repository. Three cohorts were compared: Males 60+ years (older men), females 60+ years (older women) and males under 60 years (younger men); broken down by the following variables: anatomical site, socio-economic deprivation, tumour morphology, Breslow thickness and previous occurrence of skin cancer.

Directly standardised incidence rates were calculated and Poisson regression was used to model the changes in these rates over time.

Results

Between 1990 and 2010 the melanoma incidence rate for older men varied by anatomical site (p<0.01), with the fastest rise on the trunk and upper limbs. There was no significant variation for older women (p=0.07) or younger men (p=0.89).

Melanoma incidence rates have increased irrespective of deprivation status but rates in the least deprived population increased faster for older men than younger men (7.1% vs. 3.9%; p=0.03).

The incidence rate for superficial spreading melanoma in older men increased faster (12.4%) than older women (8.9%) and younger men (7.9%), although not significantly (p>0.05).

For older men, melanoma incidence rates increased faster for thicker tumours (>4 mm; 11.5%) compared to older women (9.4%) and younger men (6.3%).

Older men had a higher proportion of previous squamous cell carcinomas than older women or younger men (p<0.01), and this proportion increased significantly faster for older men than younger men (p=0.046).

Conclusions

Epidemiological studies have consistently reported evidence that recreational sun exposure rather than chronic sun exposure is associated with melanoma risk. The new data presented here suggest that health promotion campaigns should address the risks associated with recreational sun exposure at all ages, on all body sites including the head and neck, and deliver early detection campaigns to older individuals and especially men.

*Second study: Melanoma incidence and mortality in Scotland 1979-2003,  MacKie, R M1; Bray, C; Vestey, J; Doherty, V; Evans, A; Thomson, D; Nicolson, M. Department of Public Health and Health Policy, University of Glasgow, Glasgow G12 8RZ, UK. R.M.Mackie@clinmed.gla.ac.uk. British journal of cancer 96.11 (Jun 4, 2007): 1772-7. 

About the BAD 

The British Association of Dermatologists (BAD) is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease. The BAD provides free patient information on skin diseases and runs a number of high profile campaigns, including Sun Awareness, which runs from May to September annually and includes national Sun Awareness Week in May. Website: www.bad.org.uk/sunawareness

Published on September 2, 2014