We support the view of Brougham et al that monitoring the control of non-melanoma skin cancer (NMSC) in New Zealand has not been given enough emphasis.1 NMSC is an important cancer in New Zealand, as the high NMSC incidence rate and high volume of patients create considerable annual cost to the health service. In addition, NMSC was the cause of 122 deaths in New Zealand in 2007. A minimum data set should be established to monitor this cancer.
We suggest that a regional collection of NMSC be part of the New Zealand Cancer Registry, with the aim of monitoring NMSC and facilitating evaluation and research into reducing the burden of this disease.
A region with the following characteristics would be appropriate:
- A population size just large enough to obtain a useful annual number of registrations. A manageable data collection is required with up to 2000 new cases of NMSC per year. Collection of data for new diagnoses of NMSC for the whole country would swamp the Cancer Registry.
- A relatively contained geographical region. A population with an easily defined geographical and health service region with sparsely populated borders.
- Low external migration, particularly among those 60 or more years of age. A place considered a retirement area would be appropriate.
- Relatively high sunshine hours. This would facilitate assessment of the short-term effects of sun exposure, a major causative agent.
- A single pathology reporting laboratory for ease of data collection.
In addition, there are likely to be advantages from using a defined DHB region regarding data collection and linkage to treatment or other data. An area of New Zealand that would appear to meet most of these requirements is the Nelson-Marlborough DHB region with a population of about 130,000 people. A published estimate of NSMC incidence2 suggests that about 750 new diagnoses of NMSC are likely in the Nelson-Marlborough region each year.
We suggest that the feasibility of establishing a complete, timely, and accurate NMSC collection for the Nelson-Marlborough DHB as part of the New Zealand Cancer Registry be assessed. The scope of the Cancer Registry Act to cover such a data collection also needs to be examined.
Mary Jane Sneyd