Northland’s high melanoma death rate prompts specialist training for doctors

Northland has one of the highest melanoma death rates in New Zealand – 20% higher than the national average. Picture/File

A new skin cancer initiative aimed at improving melanoma diagnosis and reducing Northland’s high death rates is set to expand nationwide.

Skin cancer continues to be a major health concern in Aotearoa New Zealand, with direct health care costs related to skin cancer treatment estimated at $123.10 million.

Northland has one of the highest melanoma death rates in New Zealand – 20% higher than the national average.

This is said to be due to a higher ultraviolet light index in Northland and the fact that Northlanders are likely to spend more time outdoors, both for recreation and for work.

Northland’s population also tends to be much older than the national population (median age for Northland 42.6 vs. 37.4 – national average) – with melanoma being most common with age.

Northland and Wanganui tied for the highest death rates with 6.0 and 6.4 melanoma deaths per 100,000 people, respectively, which equates to about 12 melanoma deaths per year.

Northland doctor Dr Christian Weiser said early diagnosis of skin cancer melanomas could be successfully and easily treated if found in time.

He said to always check for anything that seemed to be different from other points on the body or “stand out”.

“Other features of particular concern are if the spot bleeds, itches or hurts, grows/changes or has multiple colors, then it definitely needs to be evaluated as soon as possible,” Weiser said.

“The asymmetry and irregular border of a spot should also raise suspicion.

“The best way to prevent melanoma is to protect the skin from UV rays using the 5 S’s (slip/slip/snap/fetch/slip).”

According to Weiser, detecting melanoma was difficult because New Zealand lacked sufficient numbers of dermatologists and properly trained health care providers to check for suspicious skin lesions, especially in rural areas.

Dermoscopy is a relatively new technique used to examine and diagnose skin cancer, but a lack of training standards meant there was significant variation in the diagnosis and treatment a patient could receive.

Fellow of Skin Cancer College Australasia (SCCA), Dr Franz Strydom, said the organization is expanding its dermoscopy training and accreditation program to ensure a consistent standard for all healthcare providers across the countries using the technology.

Strydom said more than 100 New Zealand GPs have taken part in the training so far, and physicians participating in the Accredited Skin Cancer Doctor program must pass five exams and submit more than 50 clinical case studies for assessment.

“Currently, many healthcare providers take a short course in skin cancer, including basic training with a dermatoscope,” Strydom said.

“It has been shown to help diagnose skin cancers, but more formal training in dermoscopy can lead to a 49% improvement in a doctor’s ability to diagnose a problematic lesion.

“Identifying suspicious skin spots and moles is not always an exact science, but ensuring doctors have excellent qualifications and keeping their knowledge up to date improves patient outcomes.”

Any health care provider who participates in the accreditation program will also have access to colleagues to help them make a diagnosis.

“Often doctors work in isolation, especially those in rural areas,” Strydom said.

“The Skin Cancer College has created several platforms where clinicians can speak with other experts and seek a second opinion on any suspicious lesions they may find.”

Training in dermoscopy is available to all doctors, however, the courses provided by the Skin Cancer College of Australasia (SCCA) are particularly aimed at general practitioners and nurses.

There is a cost for GPs to access these courses, who generally have to fund their continuing education themselves and attend at their own pace.

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