Most common cancer in Germany: skin cancer is often fatal
According to health experts, skin cancer is the most common cancer in Germany. With an early diagnosis there are generally good chances of recovery. But if the disease is recognized late, it is often fatal - despite modern therapies, the discovery of which has already been awarded the Nobel Prize in Medicine.
Number of skin cancers is increasing
Worldwide, more and more people are suffering from skin cancer. In this country too, the number of patients has risen sharply in recent years. Skin cancer is now the most common cancer in Germany with around 270,000 new cases per year. As the Techniker Krankenkasse (TK) wrote in a message, every seventh disease is dangerous malignant melanoma, black skin cancer. According to the health insurance fund, light skin cancer increased by over 50 percent and black skin cancer by over 30 percent between 2009 and 2015. Recognized too late, the latter is often fatal.
Germans are early detection muffle
"If skin cancer is detected early, there is a very high chance of recovery for all types," explains the German Cancer Society on its website.
However, early detection of skin cancer is not taken seriously enough by many German citizens.
This is how you recognize skin cancer
Doctors of the German Cancer Society recommend that you take a closer look at your own body in the mirror without clothing - preferably in daylight. You should pay particular attention to existing moles and new skin changes. The partner can help. Areas that are difficult to view, such as the back and the areas between the toes and the soles of the feet, should also be examined.
In addition to screening, self-examination is the best method for early detection. But skin cancer can look very different. Therefore, several factors have to be considered for the assessment. Physicians have therefore developed the ABCDE rule for support that should be used in self-examinations. If any of the following apply, a doctor should take a look at the stain. Attention should be paid to:
A: The A stands for asymmetry. Skin spots are usually evenly round, oval or elongated. Does the stain have an unusual or asymmetrical shape or has the shape of an existing stain changed?
B: The B stands for limitation. Liver spots are usually clearly separated from the rest of the skin. Is the contour of dark skin spots washed out, frayed, jagged, uneven or rough?
C.: The C stands for Color. Usually liver and pigment marks are the same color. Does the color mix with pink, gray or black dots within a stain or are there crusty overlays on one stain?
D: The D stands for diameter. Do the marks have a hemisphere shape or are they larger than five millimeters at their widest point?
E: The E stands for evolution. This is the change of a stain over time. Has the mark changed in the past three months?
As the TK announcement states, only one in five legally insured persons use free skin cancer screening every year. The University Hospital Hamburg-Eppendorf (UKE) and the University of Bremen, together with TK, have summarized these and other facts about skin cancer in their current skin cancer report 2019, which was recently presented.
UV radiation is the main risk factor
"The numbers show that skin cancer is still a serious disease that can be fatal," said Dr. Jens Baas, Chairman of the Board of the Techniker Krankenkasse.
"With the skin cancer report, we are presenting a comprehensive data analysis, want to raise awareness and explain how to consciously deal with the sun, especially in summer," explains the expert.
UV radiation is considered the most important risk factor for skin cancer.
“Most of the time, the cause of the disease was decades ago. Skin cancer takes 20 to 30 years to develop, ”explains Professor Matthias Augustin, a dermatologist at UKE and editor of the report.
Therefore, the risk of developing skin cancer increases significantly with age. As the figures of the SHI insured show, the age group of 75 to 79 year olds is particularly affected. Of these, an average of 843 out of 100,000 insured suffer from black skin cancer each year.
For comparison: In the 20- to 24-year-olds, there are only 41 out of 100,000 insured. There are also differences between the sexes: up to the age of 60, more women develop malignant melanoma than men. Then the picture is reversed.
The so-called tanning bed knee catches the eye in the statistics: "In the age group of 45- to 54-year-old women, there is a clear increase in diagnoses of black skin cancer," says Augustin.
"This could be due to the increased use of sunbeds and frequent sunbathing in previous years," explains the specialist.
Other experts recently came to the conclusion that the trend towards tanning, in particular, was taking more and more revenge in the 1970s and 1980s.
Only around one in five goes for early detection
The earlier skin cancer is recognized, the more gently the disease can be treated. In the period between 2015 and 2017, however, only one in five insured persons with statutory health insurance received early diagnosis from a dermatologist or their family doctor.
"Precisely because early detection is so important, we advise you to take the free skin cancer screenings regularly," says Dr. Baas.
“Statutory insured persons are entitled to an examination every two years. This hardly takes any time and is also not painful. TK offers its insureds this benefit from the age of 20, ”said the TK boss.
The cost of skin cancer screening is usually only covered by statutory health insurance from the age of 35.
Artificial intelligence supports the doctor
Years ago, researchers reported that artificial intelligence (AI) can detect skin cancer as reliably as medical professionals.
In the future, modern technology will support doctors in diagnosing malignant skin changes even more reliably.
Computer systems evaluate photo findings of suspicious skin areas in real time and help the doctor with the diagnosis.
"In a few years, we expect high-quality apps that can also be used by patients for the early detection of skin cancer," said Dr. Baas.
“In the near future, new technologies will help doctors to make their diagnoses more reliable and to be able to detect skin cancer earlier. The quality of care is also increasing, for example in regions where there is a shortage of dermatologists. "
Nobel prize medicine helps in the treatment
According to the TK, groundbreaking advances have been made in the treatment of black skin cancer in recent years.
Drug treatment is increasingly based on modern immunotherapeutics that help the body fight tumors itself.
Because immunotherapy is significantly more effective and tolerable than chemotherapy, it is now an integral part of everyday treatment.
"New data from approval studies showed that over 30 percent of patients with metastatic melanoma have survived more than five years," explains Professor Gerd Glaeske, drug expert at the University of Bremen, who also contributed to the report.
"This is significantly longer than with some chemotherapies," said the expert.
"For the discovery of this new active principle, the so-called checkpoint inhibitors, the Nobel Prize for Medicine was rightly awarded in 2018," says Glaeske.
The situation is similar when evaluating the TC patient data: after four years, 35 percent of the patients who received such therapy are still alive.
"With all justified joy about the new drugs, the new therapies still have to show that they are as good as promised in the studies," says Dr. Baas.
“Early detection and sun protection remain important to keep the risk of skin cancer as low as possible.”
The cause of skin cancer is usually behavioral
Despite all hereditary predispositions, skin cancer is primarily a behavioral illness.
In recent years, the focus has shifted to changing leisure time behavior as a trigger for skin cancer.
The increase in travel to sun regions and the increase in outdoor activities is seen as a possible reason for the high number of diagnoses of black skin cancer.
Avoiding excessive UV radiation and providing effective protection with clothing and sunscreen can significantly reduce the risk of developing skin cancer.
In addition, there is often a warning against tanning - and sunburn.
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“Every sunburn is one too many. Long-term UV exposure damages the skin sustainably, we have to be even more aware of that, ”says Professor Glaeske.
The specialist therefore recommends consistent sun protection, especially for children. "The report provides important information on how to deal with the sun. Because today's sunburn is tomorrow's skin cancer, ”says Glaeske. (ad)