The incidence of melanoma in South Africa: An exploratory analysis of National Cancer Registry data from 2005 to 2013 with a specific focus on melanoma in black Africans

Tod, Bianca; Kellett, Patricia; Singh, Elvira; Visser, Willem I.; Lombard, Carl; Wright, Caradee Y.

doi:10.7196/samj.2019.v109i4.13565

Cited by 21 publications

(50 citation statements)

References 24 publications

(54 reference statements)

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“…36,37 Similarly, data from the South African National Cancer Registry documented much higher melanoma incidence rate in white South Africans, 23.2 per 100,000, compared with 0.5 per 100,000 in blacks. 38 The 66 cases of melanoma in our study…”

Section: Discussionmentioning

confidence: 81%

Primary cutaneous malignancies in nonalbino and albino Africans

Okafor

Onyishi

2020

Int J Dermatology

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Background The pigmented skin of black Africans has been credited with reduction in risk of skin cancer. African albinos have inherited defects in skin melanin deposition, which predisposes them to ultraviolet radiation‐induced cutaneous carcinogenesis. We compared the manifestation of skin cancers between albino and nonalbino Africans aiming to describe the effect of pigmentation or lack of it on the epidemiological characteristics of skin cancer in Africans. Materials and methods Cutaneous malignancies seen in our institution over a 19‐year period were analyzed using SPSS statistical software. Results were presented in tables of frequencies. Continuous variables were presented as mean with standard deviation and compared with independent sample t‐test and ANOVA. Alpha level of <0.05 was considered significant. Result There were 86 albinos and 364 nonalbinos in the study. Mean age (SD) at presentation for albinos was 41 (14) years and for nonalbinos 52 (17) years. Albinos had most tumors in the head and neck region and upper extremities. For nonalbinos, lower extremities followed by anogenital region were the most common body site of cutaneous malignancy. Squamous cell carcinoma was the most common type of skin cancer in the albino and nonalbino patients. No case of malignant melanoma was diagnosed in the albino group. Conclusion Albino skin cancer patients were much younger than nonalbinos. Albinos and nonalbinos differ in body site distribution of skin cancers. Distribution of keratinocyte carcinomas in albinos parallels the reported findings in Caucasians. Albinos may have some level of protection from cutaneous melanoma in spite of hypomelanized skin.

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Section: Discussionmentioning

confidence: 81%

Primary cutaneous malignancies in nonalbino and albino Africans

Okafor

Onyishi

2020

Int J Dermatology

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“…With regards to the demographics of subjects with a confirmed diagnosis of skin cancer it is not surprising that the majority of patients were identified as white patients, as this group will be most at risk of developing skin cancer [2,12] ( Table 2). e mean age for patients with confirmed skin cancer was 65.68 and in keeping with previous reports on age for MM and NMSC that showed people over the age of 60 to have a higher incidence of skin cancer [2,12].…”

Section: Discussionmentioning

confidence: 99%

“…e number of MM cases in our study may even be underrepresented since a large percentage of MM are diagnosed in the private sector and possibly at primary care clinics and secondary hospitals without being referred to a tertiary hospital for biopsy. Tod et al found that 75% of all MM cases in South Africa are diagnosed in the private sector [12]. ere was only one case of MM diagnosed some authors consider KA as a precursor of SCC, a well-differentiated SCC or an abortive malignancy with invasive potential [35].…”

Section: Discussionmentioning

confidence: 99%

“…is shows an increase when compared to numbers from 2009 [11]. Although data on MM incidence on the African continent remain scarce, a recent study showed the overall incidence of MM for South Africa to be 2.7 per 100 000, with the incidence in the white population being significantly higher at 23.2 per 100 000 [12]. MM in darker skin types o en presents as acral melanoma (AM), a rare distinct variant of MM that arises from the palms, soles, and nail apparatus and is associated with a poorer prognosis [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

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An Analysis of Biopsies for Suspected Skin Cancer at a Tertiary Care Dermatology Clinic in the Western Cape Province of South Africa

Wet

Steyn

Jordaan

et al. 2020

Journal of Skin Cancer

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Background. Skin cancer is a growing health concern worldwide. It is the most common malignancy in South Africa and places a large burden on the public healthcare sector. There is a paucity of published scientific data on skin cancer in South Africa. Objectives. To report the findings of biopsies performed in patients with suspected skin cancer attending the Tygerberg Academic Hospital (TAH) Dermatology outpatient department (OPD) in the Western Cape Province of South Africa. Methodology: A retrospective chart review identified all patients who underwent a biopsy for a suspected skin cancer diagnosis between September 2015 and August 2016 at the TAH dermatology OPD. Results. A total number of 696 biopsies from 390 participants were identified, of which 460 were histologically confirmed as malignant lesions. The proportion of clinically suspected skin cancers that were histologically confirmed as cancer was 68%. The most commonly occurring malignancies were basal cell carcinoma (BCC) (54.8%), squamous cell carcinoma (SCC) (18.9%), squamous cell carcinoma in-situ (SCCI) (8.0%), Kaposi’s sarcoma (KS) (6.7%), malignant melanoma (MM) (6.1%), and keratoacanthoma (KA) (4.6%). The number needed to treat (NTT) for all cancers diagnosed and for MM was 1.5 and 4 respectively. BCC (89.3%) and KS (67.7%) was the most common skin cancer in the white and black population respectively. The ratio of BCC to SCC was 2.03. Conclusion. This study provides valuable scientific data on the accuracy of skin cancer diagnosis, distribution and patient demographics in the Western Cape Province of South Africa, on which further research can be based. The study highlights the burden of skin cancer on this specific population group and calls for standardised reporting methods and increased surveillance of skin cancers.

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“…It is important to note that thicker CM are associated with a significant cost escalation (ZAR 2931 (US$497) for lesions <1 mm thick, and ZAR 7149 (US$1213) for lesions >1 mm thick), providing an economic argument for screening at risk populations [12]. Most CMs in SA are diagnosed in the private sector [13]. Melanoma is considered by one of the largest private medical insurers to be amongst the top ten cancers by cost within the scheme, with an average cost per member of ZAR 60,926 (as at Jan-Dec 2017) [14].…”

Section: Costs Due To Skin Cancer In South Africamentioning

confidence: 99%

The Incidence of Skin Cancer in Relation to Climate Change in South Africa

et al. 2019

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Climate change is associated with shifts in global weather patterns, especially an increase in ambient temperature, and is deemed a formidable threat to human health. Skin cancer, a non-communicable disease, has been underexplored in relation to a changing climate. Exposure to solar ultraviolet radiation (UVR) is the major environmental risk factor for skin cancer. South Africa is situated in the mid-latitudes and experiences relatively high levels of sun exposure with summertime UV Index values greater than 10. The incidence of skin cancer in the population group with fair skin is considered high, with cost implications relating to diagnosis and treatment. Here, the relationship between skin cancer and several environmental factors likely to be affected by climate change in South Africa are discussed including airborne pollutants, solar UVR, ambient temperature and rainfall. Recommended strategies for personal sun protection, such as shade, clothing, sunglasses and sunscreen, may change as human behaviour adapts to a warming climate. Further research and data are required to assess any future impact of climate change on the incidence of skin cancer in South Africa.

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The incidence of melanoma in South Africa: An exploratory analysis of National Cancer Registry data from 2005 to 2013 with a specific focus on melanoma in black Africans

Abstract: This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

Cited by 21 publications

References 24 publications

Primary cutaneous malignancies in nonalbino and albino Africans

Primary cutaneous malignancies in nonalbino and albino Africans

An Analysis of Biopsies for Suspected Skin Cancer at a Tertiary Care Dermatology Clinic in the Western Cape Province of South Africa

The Incidence of Skin Cancer in Relation to Climate Change in South Africa

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