'Wake-up call': Research reveals Queensland's skin cancer burden

Researchers have laid bare the huge skin cancer burden on Queensland with a new study suggesting residents in mid-life collectively undergo about 1.5 million procedures for the disease a year, costing hundreds of millions of dollars.

The study, led by QIMR Berghofer Medical Research Institute and Cancer Council Queensland, has triggered calls for more investment in skin cancer prevention campaigns to ease the enormous pressure on the healthcare system.

It comes as separate research by QIMR Berghofer suggests that even spending short times outdoors during hours of low sunlight can cause DNA damage and contribute to skin cancer risk.

That goes against decades of thinking that spending time outdoors early or later in the day does not cause harm to the skin.

The first study tracked more than 40,000 Queenslanders aged between 40 and 69 for eight years, analysing skin cancer services and associated costs through the Medical Benefits Schedule, the Pharmaceutical Benefits Scheme, and Queensland hospital admission data.

It found the research participants — all part of QSkin, the world's largest study into skin cancer — underwent about 245,000 skin cancer procedures, costing taxpayers more than $43 million across the eight years.

After comparing the data with government spending on the participants for other medical conditions, the researchers say skin cancer accounts for about 2.4 per cent of all direct healthcare costs.

Based on the findings and the sunshine state's population of two million 40 to 69-year-olds in 2025, the researchers estimate Queenslanders in mid-life collectively account for about 1.49 million skin procedures every year.

Their study found 71 per cent of the QSkin participants had used at least one skin cancer service, half had undergone one or more skin biopsies, and more than a third had one or more non-melanoma skin cancers cut out.

Thirty-four per cent had a mole or spot removed to rule out melanoma, five per cent had a melanoma excised and eight per cent required admission to hospital for skin cancer treatment.

The study, published in the Australian and New Zealand Journal of Public Health, found the highest users of skin cancer services were more likely to be older, male, have private health insurance, and be less educated than non-users.

Research is a 'wake-up call'

Cancer Council Queensland economist Daniel Lindsay, the lead author, said the most cost-effective way for reducing costs of treating skin cancer to the healthcare system was prevention campaigns.

"We know what the main risk factor is for skin cancer, it's being exposed to the sun, and that can be prevented," Dr Lindsay said.

"We're seeing TikTok influencers who are starting to promote tanning as a good thing. That then contributes to higher sun exposure, riskier behaviours, and that's probably going to see in the future perhaps an uptick in skin cancers in Australia.

"It's hugely important that we … bring it back into Australia's mindset that getting a tan is not such an appealing thing and it does have negative outcomes."

Senior study author David Whiteman, of QIMR Berghofer, said the research was a "wake-up call".

He called for more targeted skin cancer prevention campaigns.

"Skin cancer prevention has never been easy. It's always been challenging," he said.

"We just have to innovate with each new generation. It's hard now with the media landscape being so different and so fragmented.

"We need to be multicultural, we need to reach people who don't have English as their first language, we need to reach people in remote and outback communities, people in offices, people in different work settings, so it's a very targeted approach that we try and capture everybody and don't leave anybody out."

UV radiation damages DNA

Professor Whiteman is also an author on another skin cancer study, led by QIMR colleague Rachel Neale, which found that UV radiation, delivered at doses recommended to maintain adequate vitamin D status, leads to "measurable DNA damage".

The researchers exposed six areas on the lower backs of 55 healthy adults aged 18 to 55 with light to olive skin, to ultraviolet rays, delivered at lower and higher intensities, over four days.

Biopsies were taken to test for DNA damage.

Study authors said the doses given were not enough to cause the skin of participants to become pink, but even the lower doses of UV caused detectable DNA damage.

"People potentially get lulled into a sense of security when the intensity of sunlight is weak and they spend too long outdoors without adequate protection,"

Professor Neale said.

Professor Whiteman said the study showed that episodes of "incremental, incidental UV exposure" would have a cumulative impact on the skin and could lead to mutations capable of initiating skin cancer.

The researchers say the study, published in the journal Photochemistry and Photobiology, reinforces the idea of using sunscreen as part of a daily habit, to protect the skin when exposed for short, unexpected periods of sun exposure that happen as part of daily life.

More participants needed

Griffith University's Vinod Gopalan, an expert in molecular cancer pathology, said it was a good study to educate people about the need to wear sunscreen when outdoors.

But he said the study should be replicated with many more participants, including people with a family history of skin cancer and those with different skin colours, given Australia's multi-cultural society.

"It has only got 55 participants," Associate Professor Gopalan said.

"It provides valuable preliminary evidence, but larger studies involving more diverse populations, including varying genetic susceptibility to skin cancer, are needed to confirm how broadly these findings apply."

Professor Gopalan welcomed the earlier study on the cost of skin cancer to the Queensland community.

"It's such an important topic," he said.

"The positive thing about this study is they haven't just looked into melanoma. Often, we talk about just melanoma.

"Non-melanoma skin cancers are much higher in number."

He said non-melanoma skin cancers (basal cell and squamous cell carcinomas) were associated with escalating healthcare costs and patients diagnosed with them often required long-term management.