Skin cancer: Which EU countries have the highest melanoma incidence and mortality rates?

New anti-sunscreen trend on social media might amplify already rising skin cancer rates
New anti-sunscreen trend on social media might amplify already rising skin cancer rates Copyright Euronews/Canva
Copyright Euronews/Canva
By Camille Bello
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The EU cancer body places melanoma as the sixth most common cancer for both men and women. Meanwhile, some “influencers” are advising against sunscreen.

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Amidst anti-vaxxers and moon landing sceptics, anti-sunscreen ‘influencers’ have emerged on social media.

The self-proclaimed wellness gurus threatening skin cancer prevention efforts claim sunscreen is detrimental to the skin and merely a ploy by pharmaceutical companies to generate profits.

Their assertions have gained an audience with one such fitness coach reaching a quarter of a million people on Instagram.

But the scientific consensus strongly supports using sunscreen as a vital safeguard against harmful ultraviolet (UV) radiation, short-term and long-term damage to the skin from the sun’s rays, and skin cancer.

And while not many Europeans are vigilant about wearing sunscreen, melanoma, a form of skin cancer, is the sixth most common cancer in men and women after breast, colorectal, prostate, lung and bladder cancers.

Sunscreen prevents skin cancer, experts say

The American Academy of Dermatology Association - the largest, most influential, and representative dermatology group in the United States - recommends people of all races and ages use sunscreen daily.

"Sunscreen use can help prevent skin cancer by protecting you from the sun’s harmful ultraviolet (UV) rays," the website reads.

"Anyone can get skin cancer, regardless of age, gender, or skin tone. In fact, it is estimated that one in five Americans will develop skin cancer in their lifetime."

"Regular daily use of SPF 15 sunscreen can reduce your risk of developing squamous cell carcinoma (SCC) by about 40 per cent and lower your melanoma risk by 50 per cent," advises the Skin Cancer Foundation on its website.

Squamous cell carcinoma of the skin is the second most common form of skin cancer, characterised by abnormal, accelerated growth of squamous cells - a type of epithelial cell that make up the outermost layer of the skin (epidermis). When caught early, most SCCs are treatable.

Melanoma is an aggressive form of skin cancer that begins when the cells known as melanocytes (the cells that give the skin its tan or brown colour) start to grow out of control. While Melanoma is less common than SCC, it is more dangerous because of its ability to rapidly spread to other organs if not treated at an early stage.

Just 10 per cent of Europeans say they routinely or often used all forms of sun protection - such as applying sunscreen, staying in the shade, wearing a hat and protective clothing all year round, compared to 14 per cent amongst those outside of Europe.

“That's a pretty small number,” says Dr Fayne Frey, a US-based dermatologist who specialises in independent reviews.

The doctor says she recognises people’s worry about some of the chemicals included in sunscreens, "[it] is a good concern [that] the industry is looking into it," she notes.

"But now, the benefits of applying sunscreen - all FDA-approved sunscreens, including those in Europe - outweigh the downsides to not applying them," she said to Euronews Next.

Prevalence of skin cancer in Europe

Skin melanoma accounted for 4 per cent of all new cancer diagnoses in EU-27 countries in 2020 and 1.3 per cent of all deaths due to cancer, according to the European Cancer Information System.

It also stands among the top 20 causes of cancer-related mortality.

Over 100,000 new melanoma cases were reported in 2022 - most of them in adults of ages 45-69 - leading to over 15,000 deaths.

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Men are more likely to develop melanoma than women. One in every 74 women has a lifetime risk (ages 0-74) of developing skin cancer, compared to one in every 66 men.

The EU countries with the highest melanoma incidence rates (men and women combined) are Denmark, the Netherlands, Sweden, Finland and Germany. The countries with the lowest rates are Romania, Bulgaria, Cyprus, Portugal and Poland.

The EU countries with the highest mortality from melanoma (men and women combined) are Spain, Greece, Portugal, Malta and Romania. The countries with the lowest mortality are Slovakia, Denmark, Slovenia, Croatia, Sweden and the Netherlands.

Research suggests that the Nordic region, despite its limited sunlight exposure, experiences intense periods of UV radiation during the summer months, leading to a higher incidence of melanoma. This is further compounded by the prevalence of fair skin and increased susceptibility to sunburns among the population in these regions.

“There is now more and more evidence that intermittent burns increase the risk of melanoma skin cancer,” Frey explains.

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As per the findings from the Karolinska Institute, a renowned research-led medical university in Sweden, the increased risk of developing recurrent melanoma among Swedes can be attributed to two primary factors: more active sunbathing and increased travel to sunny destinations.

In line with findings from Sweden, a separate study published in the scientific journal Medicine examined the increasing trend of melanoma incidence in Denmark, concluding that the probable cause was attributed to changes “in sun exposure patterns including increased travelling since the 1960s and the introduction and spread of sunbed facilities in 1980.”

Despite a high incidence, Nordic countries have some of the highest melanoma survival rates in the EU. And across the bloc, the five-year survival of melanoma patients is highest in Western Europe and lowest in some Eastern European countries, reflecting “variations in cancer management and treatment.”

“This is but the tip of the iceberg,” writes Ana-Maria Forsea, professor at the oncologic dermatology department at Carol Davila University of Medicine and Pharmacy, in Romania, in an open-access scientific journal.

The basis of the disparities in survival rates, Forsea notes, is due to essential differences in the sources and availability of access to prevention, early diagnosis to access to treatment, “and—not least important—to the availability and accuracy of the epidemiological data.”

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