Why is skin cancer killing more men?
National Skin Cancer Action Week, from 20-26 November, is a reminder that nearly twice as many men as women die from melanoma in Australia every year.
Australia has the highest rate of skin cancer in the world, with approximately two in three Australians diagnosed with skin cancer during their lifetime.
Six people a day die from skin cancer in Australia, four men and and two women. In 2021, there were 2,220 deaths from melanoma and other malignant neoplasms of skin, 1,472 of these deaths were male and 748 were female.
Here we examine 6 possible reasons why men are at greater risk of dying from skin cancer than women.
1. Sex Differences in Cancer Risks
Certain biological differences can increase our risk of skin cancer. For example, men and women who have fair skin or light-coloured hair and who have lots of moles or a family history of skin cancer are at increased risk.
Men in general may also be at increased risk of melanoma because of differences in male and female skin. Men's skin is thicker than women's skin, with more collagen and elastin fibres and less fat beneath the surface.
Research has found that the sun’s ultraviolet (UV) rays are more likely to damage men's skin, because of these differences, while women's skin may also be better at repairing the damage caused by UV rays.
There are also significant differences in the parts of the body that skin cancer occurs in men and women. Women are 3x more likely than men to get skin cancer on their legs while men are twice as likely to get skin cancer on their trunk and 50% more likely to get skin cancer on the head and neck.
Men face greater risk of exposure to solar ultraviolet radiation than women throughout their working lives and may be less likely to engage in preventative measures, such as wearing sunscreen.
At a systemic level, cancer prevention programs are more likely to be targeted at women than men (e.g. national programs for breast and cervical cancer). Despite the fact that men are twice as likely to die from skin cancer than women, there are no national programs in place to tackle skin cancer in men.
Every year an estimated 34,000 non-melanoma skin cancers and 200 melanomas are caused by exposure at work.
Men are more than 5x more likely to be exposed to ultraviolet radiation at work than women. Around 2 million workers are exposed at work and 84% of them are men.
The workers at greatest risk are farmers, painters, plumbers, heavy vehicle drivers, animal and horticultural workers, and handymen.
Some Australian researchers argue that workplace regulations need to be strengthened to protect workers from the harms of overexposure to sunlight.
4. Skincare and Prevention
In general, men are less-likely to engage in skincare than women, who are more likely to use make-up and other cosmetics that include SPF.
Recent research commissioned by the Cancer Council found that less than half (49%) of Australian men regularly seek shade to protect themselves from the sun during summer, and less than a third (29%) regularly use sunscreen.
5. Effective Screening
Skin cancer is almost entirely preventable with early detection and treatment the key to survival. There is no national screening program for skin cancer with the majority of melanomas detected by the patient or their partner.
Men's involvement in skin cancer screening is complex. While some researchers highlight the fact that men are less likely to get screened for skin cancer than women, other research shows that men are 50% more likely to be over-diagnosed for melanomas than women.
It is generally agreed that universal screening of all men for skin cancer would not be beneficial. Men at the highest risk of developing skin cancer would benefit from regular screening, however the mechanisms in place for assessing and targeting men at risk are limited.
6. Lack of Gender Sensitive Policy and Practice
According to Global Action for Men's Health (GAMH), men bear an excess burden of cancer, in terms of both incidence and mortality
They argue that the excess burden of cancer in men must be addressed as part of the effort to address inequalities in cancer outcomes. GAMH says there is good evidence that male-targeted approaches can help to change men’s health behaviours and improve their use of services.
Their recent report on Men and Cancer called for tailored policy responses on men and cancer, improving health literacy in males from an early age and including gender as a core indicator in cancer and wider health policies.