Risk profiling may be key to lowering melanoma deaths

Media release, 5 April 2013
Individual risk profiling may be key to lowering melanoma death rates

Identifying people who are at higher risk of melanoma skin cancer and targeting them for increased preventive activities, early diagnosis and surveillance may be the key to reducingNew Zealand’s high death rate of melanoma, delegates to the National Melanoma Summit in Wellington heard today.

Dr Mary Jane Sneyd, from the Department of Preventive and Social Medicine at the University of Otago, has recently developed a New Zealand-specific prediction model to estimate an individual’s risk of developing melanoma. Her involvement in the Summit is sponsored by the Melanoma Foundation of New Zealand.

New Zealand has one of the highest rates of melanoma in the world, and over 300 people here die of melanoma each year.

Dr Sneyd says the rate of new cases of melanoma continues to rise and the thickness of melanoma at diagnosis, the major factor that determines survival, is also increasing.

“The proportion of very thick melanomas – more than 4mm – at diagnosis is going up at a faster rate than thin ones, and has increased by about 40 percent since 1996.

“Only about 8 percent of people with a very thin melanoma will die within 10 years, but 50 percent of those with a very thick one will die within that time.

“It would be nice to prevent all melanomas, but to decrease the number of deaths we want to decrease the incidence of thick melanomas and get as many diagnosed as possible, as thin as possible. To help this we need to identify those who are at a high risk of developing melanoma.”

Dr Sneyd’s prediction model takes all the risk factors such as skin type, hair and eye colour, sun exposure and family history and puts the information through a rigorous statistical process to estimate an individual’s risk of developing melanoma.

“These people can then be targeted with different types of preventive activities, early diagnosis or surveillance. When resources are scarce, we need to target our efforts where they will potentially deliver the most benefit.”

Dr Sneyd is now refining her risk prediction model to see if it can be used to predict those people who will develop thick melanomas.

She says it’s not known why there are aspects of melanoma in New Zealand that are quite different from other parts of the world that have similar high sun exposure levels, such as Australia and California.

“For example, in 2003-2007, New Zealand had a 40 percent higher melanoma death rate among women than Australia.”

A risk predictor model has been developed in the United States, but Dr Sneyd says it doesn’t apply to New Zealand because our risk is so much higher.

“There’s some sign that the rate of melanoma has decreased slightly in the youngest age group, adults 15-34 years. But we don’t know if that will continue as this group ages. They may still get them later, or even get lots more. We just don’t know.”

Melanoma Summit New Zealand 2013, with the theme ‘Connecting melanoma expertise in New Zealand’, is hosted by MelNet with support from the Health Promotion Agency, Cancer Society of New Zealand and Melanoma Foundation of New Zealand.

Sponsors of the Melanoma Summit are: Roche Products, Cancer Society of New Zealand, Genesis Oncology Trust, Path Lab, Melanoma Foundation of New Zealand, Bristol-Myers Squibb, Abbott Molecular and New Zealand Dermatological Society.

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