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The chart shows the highest and lowest EU countries for melanoma incidence. On the surface, a picture of where safety lies but not the case.
There is no doubt that Nordic countries, along with the Netherlands and Germany have the highest skin cancer rates. However, low incidence countries such as Bulgaria, Portugal and Romania have worse skin cancer survival rates.
Much can be learned from the apparent contradiction for all of us, including those in the UK. Together with melanoma, which causes most fatalities, similar patterns can be seen across a range of skin cancers.
Underlying Factors
One factor is skin type, with fair skinned populations more susceptible to skin cancer. This does not mean that everyone shouldn’t take care on sun exposure but ethnic make up does have an influence.
The Nordic region may have low overall sunlight, yet experiences intense periods of UV radiation during the summer months. DNA damaging sunburn rates are high in northern Europe, at home, or during travel to warmer countries.
Decades of growth in travel and sunbed use have worsened the situation, although Northern Europe still produces better melanoma survival rates.
Lower skin cancer incidence in southern and eastern Europe is partly due to ethnicity, along with lack of recognition and reporting. A factor which has a direct relationship with low survival rates in those countries.
Prevention & Cure
Despite higher sun exposure, native sunscreen use in northern Europe is about 40% higher than in the south. People there tend to feel more immune, which may be part of the reason skin cancer has a lower profile.
Reporting of lower level skin cancers is rarer and seeing all of them reported at a late stage more common. Recognition of symptoms amongst local medical staff can vary, cancer management and treatment are not always ideal when issues are detected.
Criticising entire countries is unfair and there will be fine centres but overall support is less certain. The same may be the case on promoting preventative measures, or the value which comes from early diagnosis.
There is a need to consider statistical accuracy. Professor Forsea, an oncologist in Romania suggested “..the availability and accuracy of epidemiological data.” as a factor but differences do clearly exist.
Lessons To Learn
Over 100,000 new melanoma cases were reported in Europe in 2022, expected to lead to 15,000 deaths. Many of those would be prevented by early diagnosis and treatment, along with reduced seriousness for other skin cancers.
Checking your skin regularly and seeing a dermatologist as soon as you suspect a problem are important. This is not being over concerned, just a rational action, which can reduce required treatment, or save your life.
Neither is prevention anything but common sense, applying sunscreen, time in the shade, wearing a hat and protective clothing. A sound move for all ages and races, we can all suffer from skin cancer.
Accurate diagnosis and prompt skin cancer treatment are thankfully available in the UK, still better if the need can be reduced.