Northland's high melanoma mortality rate prompts specialist training for doctors

Northland has one of New Zealand's highest rates of melanoma mortality - 20 per cent higher than the national average. Photo / File

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

Skin cancer continues to be a major health problem in Aotearoa New Zealand, with the direct healthcare costs of treating skin cancer estimated at $123.10 million.

Northland has one of New Zealand's highest rates of melanoma mortality – 20 per cent higher than the national average.

This is said to be due to a higher ultraviolet light index in Northland and the fact Northlanders likely spend more time outdoors, both recreationally and occupationally.

Northland's population tends to also be significantly older than the national population (Northland median age 42.6 versus 37.4 - national average) - with melanoma most common with age.

Northland and Wanganui are tied for the highest rates of mortality with 6.0 and 6.4 deaths from melanoma per 100,000 people respectively- equating to around 12 deaths from melanoma per year.

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

He said to always check anything new that appeared to be different to other spots on the body or which 'stood out'.

"Other features of particular concern are if the spot is bleeding, itchy or sore, if it is growing/changing or if it has multiple colours, then it should definitely be assessed as soon as possible," Weiser said.

"Asymmetry and irregular border of a spot should also raise suspicion.

"The best way to prevent melanoma is to protect the skin from UV radiation using the 5 S's (slip/slop/slap/seek/slid)."

According to Weiser, it was difficult to detect melanoma as New Zealand was lacking a sufficient number of dermatologists and properly trained healthcare providers to check suspicious skin lesions, particularly in rural areas.

Dermoscopy is a relatively new technique used for examining and diagnosing skin cancer however a lack of training standards had meant there was significant variation in the diagnosis and treatment a patient could receive.

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

Strydom said more than 100 New Zealand GPs had taken part in the training so far and participating doctors in the Accredited Skin Cancer Doctor programme must complete five exams and submit more than 50 clinical case studies for assessment.

"Currently many healthcare providers attend a short course on skin cancer including basic training with a dermatoscope," Strydom said.

"This has been proven to help with diagnosing skin cancers, but more formal dermoscopy training can result in a 49 per cent 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 healthcare provider who takes part in the accreditation programme will also receive access to colleagues to assist them with diagnosis.

"Often doctors work in isolation, particularly those in rural areas," Strydom said.

"The Skin Cancer College has created multiple platforms where clinicians can confer with other experts and seek a second opinion on any suspicious lesions they may find."

Dermoscopy training is available to all doctors, however, the courses run through the Skin Cancer College of Australasia (SCCA) are particularly aimed at general practitioners and nurses.

There is a cost for general practitioners to access these courses, who generally have to fund their own further education and attend in their own time.

To find out more about melanoma, visit: www.melanoma.org.nz/prevention.

To find a doctor with extra skills in diagnosing and treating skin cancer, visit: www.nzscd.org.nz/full-members.html.