In 2020, NMSC accounted for 78% of all skin cancer cases, resulting in over 63,700 deaths, and melanoma caused an estimated 57,000 fatalities in the same year. 

Non-melanoma skin cancer (NMSC) is causing a greater number of global deaths than melanoma, according to a new study presented at the European Academy of Dermatology and Venerology (EADV) Congress 2023 in Berlin, Germany.

Researchers also believe that NMSC is underreported and that the true impact of this disease may be even higher than estimated.

Although NMSC is less likely to be fatal than melanoma skin cancer, its prevalence is strikingly higher. In 2020, NMSC accounted for 78% of all skin cancer cases, resulting in over 63,700 deaths. By contrast, melanoma caused an estimated 57,000 fatalities in the same year. 

“The significantly higher incidence of NMSC has, therefore, led to a more substantial overall impact,” says study author Professor Thierry Passeron, MD, PhD, a professor and the chair of the Department of dermatology at the Université Côte d'Azur in Nice, France, in a news release.

Professor Passeron adds, "As alarming as these figures are, they may be underestimated. NMSC is often underreported in cancer registries, making it challenging to understand the true burden."

In addition to examining the overall burden of skin cancers, the researchers identified specific population groups that were more at risk of this disease, including people who work outside, organ transplant recipients, and those who have the skin condition xeroderma pigmentosum.

The study, which utilized data from the World Health Organization International Agency for Research on Cancer, found a high incidence of skin cancer in fair-skinned and elderly populations from the USA, Germany, the UK, France, Australia, and Italy. However, even countries with a high proportion of dark phenotypes were not immune to the risk of death from skin cancer, as demonstrated by the registered 11,281 deaths in Africa.

In 2020, there were nearly 1.2 million reported cases of NMSC worldwide compared with 324,635 cases of melanoma. The majority of skin cancer occurrences are non-melanoma, referring to a group of cancers that slowly develop in the upper layers of the skin, with common types including basal cell carcinoma and squamous cell carcinoma. In comparison with melanoma, a type of skin cancer that develops in the melanocytes, NMSC is less likely to spread to other parts of the body and can be treated more easily.

Professor Passeron adds, “We have to get the message out that not only melanoma can be fatal, but NMSC also. It's crucial to note that individuals with melanin-rich skin are also at risk and are dying from skin cancer. There is a need to implement effective strategies to reduce the fatalities associated with all kinds of skin cancers.”

The new study did not find consistent evidence to suggest that having more dermatologists per capita could reduce mortality rates. Countries like Australia, the UK, and Canada, with fewer dermatologists, exhibited low mortality-to-incidence ratios. 

“We therefore need to explore what strategies these countries are employing to reduce the impact of skin cancer in further depth,” he says. “The involvement of other healthcare practitioners, such as GPs, in the identification and management of this disease may partly explain their success. There remains a huge opportunity worldwide to elevate the role of GPs and other healthcare professionals in this process and train them to recognize suspicious lesions early.”

There is an ongoing need to develop awareness campaigns that educate the general public about the risks of sun exposure and other relevant risk factors, according to Professor Passeron.

“These campaigns should be tailored to at-risk populations, including those with fair skin, outdoor workers, the elderly, and individuals who are immunosuppressed," he adds. "Importantly, these efforts should also extend to populations that may not typically be considered at high risk, such as darker-skinned populations."