Using linked data to inform targeted skin cancer screening in Australia

Age and sex

Between the 2016 Census night and 31 December 2022, about twice as many people had died from melanoma (7,900 deaths, or 32 deaths per 100,000 people) than NMSC (3,800 deaths, or 15 deaths per 100,000 people).

Melanoma and NMSC death rates were higher for males (46 deaths per 100,000 and 23 per 100,000, respectively) than females (20 deaths per 100,000 and 8.1 per 100,000, respectively).

Death rates also increased with age, although melanoma deaths started increasing sharply at an earlier age than NMSC (Figure 3).

Indigenous status

Age-standardised melanoma death rates were lower for First Nations people (18 deaths per 100,000) than for non-Indigenous Australians (32 per 100,000) but age-standardised NMSC death rates were similar (16 deaths per 100,000 and 15 per 100,000, respectively).

The chance of being diagnosed with skin cancer is generally lower for First Nations people than non-Indigenous Australians. This may be partly explained by higher skin pigmentation among First Nations people. Skin cancers are more common with greater exposure to UV radiation and are less frequent in people with higher skin pigmentation (Nguyen et al. 2025).

It should be noted that, while First Nations people have lower rates of skin cancer, deaths from these cancers can still occur.

Culturally and linguistically diverse Australians

People with Oceanian ancestry (this includes Australian peoples, New Zealand peoples, Melanesian and Papuan peoples, Micronesian peoples and Polynesian peoples) or who were born in Oceania and Antarctica (this includes people born in Australia, New Zealand, Melanesia, Micronesia, Polynesia and Antarctica) had the highest age-standardised death rates from skin cancer (Figure 4).

Melanoma death rates were highest for people born in Australia (including external territories; 40 deaths per 100,000 people) and New Zealand (37 deaths per 100,000 people). NMSC death rates were highest for people born in Australia (including external territories; 19 deaths per 100,000 people).

People born in Asia or with Asian ancestry had the lowest death rates from skin cancer.

Disability status

Severe or profound disability refers to people who need assistance in one or more of the three core activity areas of self-care, mobility and communication, because of a long-term health condition (lasting six months or more), a disability (lasting six months or more), or old age.

Age-standardised melanoma and NMSC death rates were twice as high for people with severe or profound disability (60 deaths per 100,000, and 30 per 100,000, respectively) than for those without severe or profound disability (31 deaths per 100,000, and 13 per 100,000, respectively).

The prevalence of disability generally increases with age. For people aged 65 and over, about 50% of people have disability, with around 15% of males and 20% of females aged 65 and over experiencing severe or profound disability (AIHW 2024b). Similarly, deaths from melanoma and NMSC increase with age and this likely accounts for some of the increased risk for people with severe or profound disability.

Another reason for why death rates are higher for those with severe or profound disability might be challenges related to self-care and access to health care appointments. For example, people with vision issues might have difficulty in noticing early signs of skin cancer and those with mobility issues might have difficulty in accessing skin checks (Bowers et al. 2023). Delays in detecting skin cancers might result in worse mortality outcomes.

Geographic and socioeconomic areas

Age-standardised melanoma death rates were highest for people living in regional areas of Australia (Figure 5) and for people living in the most disadvantaged socioeconomic areas (Figure 6).

Age-standardised NMSC death rates were highest for people living in Remote and Very remote areas of Australia (Figure 5) and for people living in the most disadvantaged socioeconomic areas (Figure 6).

People living in Major cities and Remote and Very remote areas of Australia have lower age-standardised rates of melanoma (both incidence and mortality) than those in Inner regional and Outer regional areas.

One reason could be occupational exposure. People who work in outdoor jobs are exposed to more ultraviolet radiation, and outdoor workers are more likely to live in regional and remote areas (Carey et al. 2014). Another factor is that First Nations people have a lower risk of melanoma, and about 30% of people in Remote and Very remote areas identify as First Nations people (AIHW 2024c). This may help explain why melanoma rates are lower in remote areas than in regional areas.

While the national age-standardised melanoma death rate for the project population was 32 deaths per 100,000 people, 4 Primary Health Networks (PHNs) had an age-standardised death rate of 40 or more per 100,000 people:

• Hunter New England and Central Coast (NSW)
• North Coast (NSW)
• Central Queensland, Wide Bay, Sunshine Coast (Qld)
• Northern Queensland (Qld).

These PHNs are on the New South Wales and Queensland coast, which have higher rates of melanomas diagnosed (Australian Cancer Atlas 2025).

These areas also had relatively high NMSC death rates, as did non-coastal PHNs such as the Northern Territory (NT) and Country WA (WA).

Death rates for melanoma and NMSC were highest among the population living in the most disadvantaged socioeconomic areas (1 – lowest; about 20% of the Australian population). This may be partly because people in higher socioeconomic areas have better access to health services and skin checks, leading to earlier detection of melanoma. A recently published Queensland study suggested that people living in lower socioeconomic areas were more likely to be diagnosed with a late-stage melanoma than those living in the highest socioeconomic areas (Gavanescu et al. 2025).

Education and occupation

This project showed that age-standardised melanoma and NMSC death rates were highest for people whose highest level of education was a Certificate III/IV (Figure 7).

One reason for the differences in mortality by education might be occupation. Highly qualified people on the night of Census 2016 were more likely to be employed in professional occupations, such as nurses, teachers, accountants, and software programmers (ABS 2017). Those with other qualifications (such as a Certificate III/IV) were more likely to be employed as sales assistants, carpenters and joiners, electricians, and child carers.

Understanding skin cancer risks based on occupation is important since people in outdoor jobs like farming, construction and gardening are more likely to be exposed to ultraviolet radiation from the sun than those in mostly indoor jobs (Slavinsky et al. 2023) and ultraviolet radiation is a known risk factor for melanoma.

Half (51%) of the people in this project were recorded as ‘not applicable’ for their occupation status. This meant that in the week before the Census the person was either:

• unemployed and looking for full-time or part-time work
• aged under 15
• not in the labour force
• did not have a stated labour force status.

These people accounted for about 78% of all melanoma deaths and 91% of all NMSC deaths, likely because most of these deaths occur in older Australians, who are less often in the workforce (AIHW 2024a). Of the remaining melanoma and NMSC deaths that occurred in people who were actively in the labour force at the time of the 2016 Census:

• Managers had the highest age-standardised melanoma death rates (Figure 8), mainly because this group includes farmers and farm managers.
• Managers and labourers had the highest age-standardised NMSC death rates (Figure 8).

Considerations and next steps

This project linked the 2016 Census of Population and Housing and deaths registered between the 2016 Census night (09 August 2016) and 31 December 2022. The following points should be considered when interpreting the findings:

• 80% of cancer deaths recorded during the period linked to a person on the 2016 Census of Population and Housing. Deaths (counts and rates) in this report are therefore underestimates.
• Because of small numbers of skin cancer deaths recorded for some priority populations, some groups were combined to meet data confidentiality and reliability requirements. In some instances, this meant that not all ancestry or region of birth groups were reported, making it difficult to assess whether mortality outcomes were equitable.
• Priority populations were defined based on information reported on the 2016 Census night. A person’s occupation and location of usual residence (and subsequent remoteness area, socioeconomic area, and Primary Health Network of residence) may have been different when they died.

The project demonstrated that linked data assets, such as PLIDA, can provide valuable insights into skin cancer deaths for priority populations that are not readily captured in traditional data sources, such as the National Mortality Database or Australian Cancer Database.

However, this is only part of the broader picture of skin cancer in Australia.

The AIHW is continuing to work with the Department of Health, Disability and Ageing and the MIA to improve skin cancer incidence data, including:

• estimating keratinocyte skin cancer incidence (a known and ongoing data gap)
• improving data on multiple primary melanomas.

These projects will help identify future data and information needs.