We need to invest more in the prevention of skin cancer in Portugal. The conclusion is from a study by researchers from CINTESIS – Center for Health Technology and Services Research, published in the journal Cancer Epidemiology.
According to this study, there were around 90 thousand episodes of skin cancer in Portuguese public hospitals over a period of five years, of which about 16 thousand were melanomas and the remaining 72 thousand were non-melanomas.
From 2011 to 2015, the researchers evaluated all cases of hospitalizations and outpatient consultations within the National Health Service that there diagnosed as skin cancer. The objective was to determine the most common location of the lesions, the occurrence of metastases, the mortality, and also the hospital costs associated with the disease.
Patients with melanoma are younger (66 years-old) and the incidence of metastases in these patients is higher (14% of cases) and the most affected area is the upper body (32%). Patients with non-melanoma skin cancer are generally older (76 years) and have a lower mortality, although they are hospitalized for longer periods (9 days on average versus 7.3) and the costs are on average higher (2,563.00 euros against 2,417.00 euros for each hospitalization).
If we consider only the hospitalizations, melanoma was responsible for more than 35 thousand days of hospitalization, whereas non-melanoma skin cancer added up more than 73 thousand days of hospitalization. Per year, melanoma costs 3.8 million euros, while non-melanoma costs around 16.2 million euros, or about four times more than melanoma.
“We estimate the hospital costs of skin cancer in Portugal, but these numbers are probably underestimated, as they do not account for episodes in private health institutions. It is known that, with waiting lists that exceed one year in the Portuguese NHS, patients with financial resources or with health insurance are increasingly looking for the private sector. In addition, most non-melanoma cancers are not risk tumors and can be treated effectively outside the public sector,” explains Ana Filipa Duarte, a researcher at CINTESIS / Faculty of Medicine of the University of Porto (FMUP) and the first author of the study.
The dermatologist warns that with the aging of population and known risk behaviors, skin cancer cases tend to increase as well as their costs. In fact, with the introduction of new treatments, not only increases the success rate, but also the associated expense.
According to the researcher’s words “it is therefore essential to focus on strategies for the primary prevention of skin cancer and early its detection,” in order to reduce the mortality and costs of the disease.
However, prevention campaigns cannot “underestimate the importance of non-melanoma skin cancer”, both in terms of its impact on the health system and its costs, which are much higher on average than those for melanoma and for the quality of life of patients.
The authors hope that this study may contribute to greater awareness of the importance of skin cancer as a public health problem and thus enable “assertive political decisions” to be taken in the area of prevention.
Besides Ana Filipa Duarte, the researchers Bernardo Sousa Pinto, Alberto Freitas, Luís Delgado, Altamiro da Costa Pereira and Osvaldo Correia are authors of the study.