This document discusses skin cancer incidence and types. It notes that the most common types are malignant melanoma and non-melanoma skin cancer (NMSC), with over 10,400 new melanoma cases and 81,600 NMSC cases diagnosed in the UK in 2006. Melanoma is more serious but less common than NMSC. Risk factors for skin cancer include UV radiation, skin type, and family history. The document provides details on characteristics and symptoms of different skin cancer types like melanoma, basal cell carcinoma, and squamous cell carcinoma. It stresses that all melanoma cancers and complex NMSC cases should be referred to skin cancer specialists.

1. Skin cancer

2. Incidence
 Main types of skin cancer
– malignant melanoma of the skin
– non-melanoma skin cancer (NMSC).
 It has been estimated that the lifetime risk of
developing malignant melanoma is 1 in 91 for
men and 1 in 77 for women in the UK. These
were calculated in February 2009 using
incidence and mortality data for 2001-2005.

3. Incidence
 Malignant melanomas are the least common
but most serious type of skin cancer, with
more than 10,400 new cases diagnosed in
2006.
 In 2006 over 81,600 non-melanoma skin
cancers (NMSC) were registered in the UK (
registration is known to be incomplete). One
study estimated that at least 100,000 cases of
NMSC are diagnosed each year.

4. Aetiology
 UV radiation
 Skin type
 Predisposition
 Marjolins

5. Incidence
 Malignant melanoma
– Unlike most malignancies, malignant melanoma is
more common in women than men with a M:F ratio
of 4:5. In 2006 it was the sixth most common cancer
in females and the eighth in males: for both sexes
combined it was the sixth most common cancer.
– The distribution of cases on the body also varies by
sex over a third of male cases arise on the trunk of the
body, particularly the back, while the most common
site for females is on the legs.
– Malignant melanoma is rare in children, while in
adults the incidence rates rise steadily with age.

6. Malignant melanoma

7. Malignant melanoma
 Increasing incidence

8. Malignant melanoma
 Melanoma types
– Superficial spreading
 Sub group arising within lentigo maligna
– Nodular
– Acral lentiginous
– Amelanotic

9. Malignant melanoma
 Features to elicit concern
– Change – see right
– Itch
– Bleeding

10. Malignant melanoma
 Lentigo maligna
– Elderly patient
– Gradually increasing pigmentation
– Beware dark areas

11. Malignant melanoma
 Nodular melanoma
– Rapid change
– Ulceration
– Urgent

12. Malignant melanoma
 Acral lentiginous
– Refer early
– Do not observe
 Subungal
– Beware unclear history of trauma

13. Incidence
 Non Melanoma Skin cancer
– The majority of NMSCs are either basal cell
carcinomas (BCCs), also known as rodent ulcers, or
squamous cell carcinomas (SCCs). Both forms are
highly treatable and survival rates for NMSCs are over
95%.
– Whilst BCCs rarely metastasise, SCC can, and in 2006
there were 577 deaths in the UK from NMSC. Around
80% of NMSCs occur in people aged 60 years and over
and they constitute a substantial public health
problem due to the very large number of cases each
year.

14. Pre-malignant
 Pre-malignant
– Actinic keratosis
 25% progress to scc
– Bowens disease
 If progress to SCC can be aggressive
 Assoc with internal malig 7%
– Keratoacanthoma
 Rapid growth
 Central depression

15. Squamous Cell
 Two main types
– Verrucous
– Nodular

16. Basal cell
 Types
– Nodular
– Superficial
– Sclerosing
– Pigmented

17. Basal cell
 Rarely metastasizes
 Danger sites
– Inner canthus
– Alar base
– External auditory meatus

18. Treatment
 All melanoma skin cancers should be referred
to a specialist who works within a
multidisciplinary team set up to deal with the
full spectrum of this condition
 Complex or high risk non melanoma skin
cancers should be referred in a similar fashion