A dermatologist who moved from the United Kingdom to Hawke's Bay a year ago has been stunned by the amount of skin cancer in the region.
In 2018, New Zealand had the second-highest incidence age adjusted rate of melanoma in the world at 33.3 cases per 100,000 people, just behind Australia at 33.6.
Hawke's Bay in particular is a hot spot for the skin cancer - statistics from the Ministry of Health show that between 2014 and 2016, Hawke's Bay had an age-standardised melanoma death rate of 5.5 per 100,000 people, even more than the national average of 4.8.
Dr Juber Hafiji has 20 years' experience as a specialised skin cancer surgeon in the UK, but said he had never seen anything like the rate of skin cancer in Hawke's Bay.
"There's so much skin cancer here, it's quite frightening actually," Dr Hafiji said.
"The volume of skin cancer, the severity of the skin cancers that I see, and having difficult conversations with patients."
Dr Hafiji said he welcomed the message of a recent Melanoma New Zealand campaign to tackle what has been labelled "New Zealand's cancer" because of our high incidence rate.
Several advertisers got on board by replacing full stops in their advertising with spots reflecting seven visual signs of melanoma, an initiative designed to draw attention to the need for New Zealanders to notice changes to spots on their own skin.
He said previous efforts to convey the message don't appear to have got through to people, because the rates, incidents and prevalence of skin cancer is at an all-time high.
The "she'll be right" mentality of Kiwis could be contributing to that – an attitude that simply has to change, he said.
"Most skin cancers, if picked up early, can result in cure," Dr Hafiji said, adding that being proactive and knowing your own skin is an easy way to prevent the disease.
He finds it odd that people in Hawke's Bay haven't taken more action to prevent skin cancer, given everybody seems to know someone who has dealt with it.
Although he has been alarmed by the amount of skin cancer work to do, he said has arrived somewhere he can do a lot of good work for a lot of people.
"If I can see, in my working lifetime of the next 20 years, skin cancer statistics coming down in Hawke's Bay, then I'll feel as though my job has been done," he said.
That job became a little easier last Wednesday with the launch of a new practice within the Napier Health Centre offering what Dr Hafiji describes as "the gold standard" in skin cancer treatment.
The clinic was set up over the last few months, with an on-site laboratory that allows same-day analysis of skin cancer results, and day-theatre rooms.
This means Mohs Micrographic Surgery can now be used to treat certain skin cancers, an option that was not previously available in Hawke's Bay.
He said the practice will be able to remove the visible part of a cancer a thin layer at a time, taking just a very small margin of healthy skin with it.
"We immediately check the outer margins of the removed skin in our laboratory to confirm that we have removed all of the cancer," he said.
"We continue to carry out that process until all of the cancer is removed."
Dr Hafiji said the advantages of the technique are keeping wounds as small and shallow as possible, and completing surgery and analysis on the same day so patients don't have to wait for results and maybe come back for more surgery.