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Early Detection Not an Iron-Clad Guarantee
Researchers in Queensland, which has the highest melanoma rate in the world, have found that melanomas less than 1mm thick cause more fatalities than “thick” melanomas at least 4mm deep.
The findings, published in the US-based Journal of Investigative Dermatology, suggest Queenslanders are having suspicious skin markings checked out before they develop. “(But) this is not preventing people from dying,” said lead author David Whiteman. “It’s a sobering reminder that while we have been very successful at picking melanomas up early, it’s not an iron-clad guarantee.”
Professor Whiteman, of the QIMR Berghofer Medical Research Institute in Brisbane, said researchers had known for decades that advanced melanomas carried poor prognoses. “The danger is proportional to how deep they are when they’re diagnosed,” he said.
“Thin” melanomas present only marginal risks to life, leading to assumptions that most melanoma deaths arise from thick lesions. But the team’s analysis of 20 years of Queensland Cancer Registry data, which took account of tumour thickness at diagnosis, revealed this was not the case.
While late-detected melanomas proved 12 times as likely to kill sufferers as those diagnosed early, the sheer number of cases — which almost doubled from about 1500 a year in the early 1990s to 2800 late last decade — meant thin tumours killed about 40 per cent more Queenslanders, on average.
Even Thin Melanoma Tumours Can Kill You
Over 15 years, this gap has grown from 24 per cent to almost 60 per cent. “We’re seeing a shift in the patterns of the people dying from melanoma,” Professor Whiteman said. “We must prevent melanomas in the first place, because once they occur, even thin ones can kill you.”
Professor Whiteman said data from elsewhere, including the US, pointed to similar trends. He said that while the incidence of melanoma in Australians aged under 40 was declining, it remained the most common cancer among the nation’s young. “That’s why we mustn’t give up on primary prevention — the ‘slip, slop, slap’,” he said. “Melanoma is almost entirely preventable.”
The Melanoma Institute of Australia says about 400 extra cases are detected each year. One in 17 Australians can expect a diagnosis by the age of 85.
Melanomas comprise just 2 per cent of skin cancers but cause three-quarters of skin cancer deaths, the institute says.