An aggressive form of skin cancer previously thought to affect mainly white people, has been found to pose a significant threat not only to black people, but the public health sector that treats them.
This is according to the latest study on the incidence of melanoma in the country, with a specific focus on melanoma in black Africans, published in the South African Medical Journal.
Melanoma is an aggressive skin cancer with a poor survival rate when diagnosed late. If diagnosed early, the chances of a five-year survival rate is more than 90%. But, if diagnosed late, the chances of living for five years after diagnosis falls to about 20%.
“Melanoma is more common in fair than dark individuals, but it does occur in black Africans. Since the black African group is the largest in South Africa, melanoma in this group has significant public health implications,” the study’s researchers said.
The study was led by Bianca Tod from the division of dermatology at Stellenbosch University’s medicine department.
The researchers set out to analyse and describe the most recent age-standardised melanoma incidence rates in the country from the National Cancer Registry – a pathology-based registry that records all cancer cases diagnosed in both the public and private health sectors.
A total of 11 784 invasive melanomas were reported to the registry between 2005 and 2013. Of these, 5 727 cases were in women, and 6 049 were in men. The disease was highest among white people, with 8 104 cases reported, followed by 1 991 melanomas in black Africans and 1 070 in coloured people.
Western Cape and Gauteng had the highest melanoma incidence rates with nearly 75% of all skin cancers in all population groups diagnosed in private laboratories, and 75% of melanomas in black people diagnosed in the public sector.
Melanoma in black people has been known to present in the palms of the hands or on the soles of the feet, with several other studies having previously reported worse disease outcomes for melanoma patients with darker skin types – particularly thatof the hands and the feet.
This study found much the same. Melanoma in the 1 991 patients occurred mostly in the skin (92%) – with 878 having melanoma of the limbs. At least 27% of black people had melanoma in the scalp and neck regions, but a majority (71%) of the disease was found in the lower limbs and hips.
The researchers said they hoped their study would be useful to inform skin cancer awareness and screening programmes.
“[The study] highlights melanoma in black Africans, emphasising that it is a significant public health problem particularly because of late diagnosis,” the report said.
“The findings are important to increase physician awareness and to strengthen public health education for melanoma primary and secondary prevention in South Africa.”