Surgeon criticises cancer records

The Health Ministry says increased sun exposure and an ageing population mean more cases of cancer. Photo / Sarah Ivey

A leading plastic surgeon is calling for better management of non-melanoma skin cancers, after finding the annual incidence is rising by more than 4 per cent in central New Zealand.

Professor Swee Tan, supported by the Cancer Society, is critical of the lack of attention given to gathering data on non-melanoma skin cancers, but the Health Ministry's response is that they are usually minor cancers.

Melanoma is the most deadly type of skin cancer, but the other types cause many more cases and can also be fatal.

Comprehensive records are not kept of non-melanoma skin cancer. The Cancer Registry abandoned mandatory reporting of basal cell carcinoma and squamous cell carcinoma - the two main types - in 1958 because of incomplete reporting and lack of resources to manage the large number of cases.

The Cancer Society estimates there are around 67,000 new cases of non-melanoma skin cancer (NMSC) a year and 100 deaths. In 2008, about 2200 cases of melanoma and 317 deaths were recorded by the registry. The cost of treating NMSC is estimated to exceed $50 million a year.

Professor Tan, of Hutt Hospital in Wellington, said: "The lack of data in New Zealand has prevented effective service planning and delivery.

"New Zealand has one of the highest rates of non-melanoma skin cancer in the world and its increasing incidence underscores the importance of developing and implementing a national health-care delivery model ..."

Professor Tan and colleagues have published, in the Australia-New Zealand Journal of Surgery, a review based on non-melanoma skin cancer pathology records from 1997 to 2007 in the lower North Island. It indicates a 4.1 per cent per year increase in incidence.

The Cancer Society's health promotion manager, Jan Pearson, said, "It is imperative that non-melanoma skin cancers are registered in a comprehensive manner, including staging at diagnosis, treatment and outcome."

Dr John Childs, head of the Health Ministry's cancer programme, said the ministry was "aware of the concerns around the volume of of non-melanoma skin cancer in New Zealand, due to the ageing population and increased sun exposure".

"Many of these are minor cancers which can be easily managed by GPs or in outpatient minor-surgical clinics."

The numbers

* 67,000 - new cases of non-melanoma skin cancer a year in New Zealand.
* 100 - deaths a year.
* 4.1pc - annual increase in cases between 1997 and 2007.