Skin cancer statistics (FOI)

Request

I'd like to know some statistics about skin cancer in Jersey.
A

In 2012 how many cases of skin cancer were reported in Jersey?

B 

In 2012 how many people died from skin cancer in Jersey?

C 

How many cases of skin cancer have been reported in Jersey in the past five years (2021, 2020, 2019, 2018, 2017)?

D 

How many people have died from skin cancer in Jersey in the past five years?

E 

What has been the average waiting time to see a skin cancer consultant in Jersey from moment of referral (also last five years)?

F 

How many people are currently waiting to see a consultant?

G 

How many people are currently diagnosed with skin cancer and receiving treatment?

H 

How much money has the Government invested in public health campaigns highlighting skin cancer awareness?  

Response 

A

Information is publicly available on www.gov.je in response to a previous Freedom of Information request. Article 23 of the Freedom of Information (Jersey) Law 2011 applies. 

Melanoma and skin cancer FOI (gov.je) 

Additionally, information in relation to cancer diagnosis in Jersey is analysed by Public Health England through the National Cancer Registration and Analysis Service on behalf of the Channel Islands. The latest report from Public Health England can be found at the following link: 

Channel Islands Cancer Registration Report 2020 (gov.je)

Data about diagnosis in 2017 onwards will be included in the next iteration of this report. Providing data from the Jersey health systems, would include data extraction, matching and analysis from the following systems:

• Cancer Outcomes and Services dataset (COSD) from the cancer management MDT system
• pathology (including information about staging and metastasis)
• Patient Administration System (PAS)
  
• death certificates or notices
• population projections 

Compilation of this data, without information from UK data systems related to Jersey domiciled residents would not give a complete picture of diagnosis of Jersey residents, this is why data is supplied through the National Cancer Registration and Analysis Service in order to provide a complete data set of cancer diagnoses. 

To answer the request, the data would need to be extracted from various sources and manipulated, aside from taking more than the prescribed 12.5 hours to do that work, the Freedom of Information (Jersey) Law 2011 does not require a Scheduled Public Authority to manipulate data to provide a response. Article 16 of the Freedom of Information (Jersey) Law 2011 has therefore been applied.

B

In 2012 there were nine deaths in Jersey reported on death certificates, and assigned with ICD-10 codes as conditions with the following underlying causes of death of:

• C43. Malignant melanoma of skin
• C44. Other and unspecified malignant neoplasm of skin 

Source: Public Health Intelligence Mortality Database, from data recorded by Office of the Superintendent Registrar, and Viscount's Department 

Please note that this list details only those that have died with an underlying cause of ICD-10 code range for Melanoma and other malignant neoplasms of skin C43-C44. Therefore this may not necessarily include  individuals who may have died with a skin cancer, if the skin cancer did not initiate the train of events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury. 

Deaths include visitors to Jersey who have died in Jersey, but may not include all deaths of Jersey residents who have died off-island and not been repatriated. 

C

Please see response to A above. 

D

During the five year period 2016-2020 there were 38 deaths in Jersey reported on death certificates, and assigned with ICD-10 codes as conditions with the following underlying causes of death of:

• C43. Malignant melanoma of skin
  
• C44. Other and unspecified malignant neoplasm of skin
  

Source: Public Health Intelligence Mortality Database, from data recorded by the Office of the Superintendent Registrar, and Viscount's Department

Please note that this list details only those that have died with an underlying cause of ICD-10 code range for Melanoma and other malignant neoplasms of skin C43-C44. Therefore this may not necessarily include  individuals who may have died with a skin cancer, if it did not initiate the train of events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury. 

Deaths include visitors to Jersey who have died in Jersey, but may not include all deaths of Jersey residents who have died off-island and not been repatriated. 

The Channel Islands Cancer Report 2020 noted that Non melanoma skin cancer (NMSC) may not be recorded comprehensively in England and therefore the incidence may be an underestimate of cases.  Regional differences exist in the recording of NMSC, however the data registration in the Channel Islands and the South West is comparable, so we can be confident in comparing data to this region. 

The coding of deaths for 2021 is not yet complete and therefore, this information is not held and Article 3 of the Freedom of Information (Jersey) Law 2011 applies. 

Figures for 2021 will be published in line with the Public Health Intelligence Publication Release Schedule: 

Public Health Intelligence publication release schedule (gov.je)

E

Referrals to the Dermatology department are not categorised / separated to skin cancers and other (mostly inflammatory) conditions. However, a good proxy for the waiting times of patients referred with skin cancers would be waiting times for urgent referrals as reported monthly at www.gov.je. The majority of urgent referrals relate to suspected skin cancers (melanoma and most squamous cell carcinomas). The average wait of 'Urgent' waiting times reported for 2022 to date is 2.3 weeks. 

A partial audit was performed of patients diagnosed with melanoma between January and September 2021 (full melanoma audit 2021 pending) and the average waiting time for patients referred mostly by their GPs as 'Urgent' with a subsequent diagnosis of melanoma was 11.1 days.

F

There were a total of 452 patients on the waiting list for Dermatology at the end of April (down from 613 at the beginning of 2022). These figures can be found on the www.gov.je website.

Health and Community Services do not have information available on how many of these patients were referred with potential skin cancers. Under the Freedom of Information (Jersey) Law 2011, departments are not required to undertake manipulation or create new data sets to provide a response. Therefore, Article 3 of the Freedom of Information (Jersey) Law 2011 applies. 

G

The official data from the latest Channel Islands Cancer Report 2020 incorporates data up to 2016. It reported 174 cases of invasive malignant melanoma diagnosed between 2014-2016 (average 58 per year). This number does not include 'in-situ' melanoma diagnoses – an early stage when the cancer is non-invasive and is practically 100% curable with surgical excision. 

The same dataset reported 1.289 non-melanoma skin cancers (mostly squamous cell carcinomas and locally invasive basal cell carcinomas) diagnosed between 2014-2016 (average 430 per year). 

As the incidence of skin cancers has been growing around the world it may be estimated that the total number of skin cancers diagnosed in Jersey in 2021 exceeded 600 cases but we do not analyse the non-melanoma skin cancers in annual audits. 

The partial audit of patients diagnosed with melanoma between January and September 2021 in Jersey (full melanoma audit 2021 pending) identified 52 new diagnoses of invasive malignant melanoma. 

It is worth mentioning that Jersey is among the countries with the highest rates in the world of diagnosing early stages of melanoma. Over 40% of all melanoma cases diagnosed between 2018-2021 until September belonged to that category with very good prognosis. It has been possible thanks to strong engagement of community doctors, nurses but also some Allied Healthcare Professionals in promoting early diagnosis. Donna Annand Melanoma Foundation also contributed to the dermoscopy training program for our GPs and provided them with state-of-the-art dermatoscopes.  

Jersey General Hospital will soon launch confocal microscopy clinics to further advance the diagnosis of skin cancers and to shorten the time from consultation to mostly surgical treatments. 

The number of new cases of melanoma diagnosed during the Covid pandemic in Jersey was similar to pre-Covid years – while for many countries including the UK the number of cancers diagnosed during the Covid pandemic was lower than before. This might reflect high priority given to promptly seeing patients with potential skin cancers during the pandemic at the Dermatology Department of Jersey General Hospital. 

H

As part of their annual operations, the Public Health team within Government prepare key media briefings to remind and spread awareness in the population about the need to practice sun safety in response to excessive summer heat and UV radiation. The Government of Jersey has also partnered with a UK-based Charity, Skcin, to deliver skin cancer prevention campaigns in Jersey schools (called the Sun Safe Schools programme). The objective of the programme is to prevent skin cancer through education by providing primary schools with a comprehensive range of free teaching resources and policy guidance to ensure children enjoy the sun safely. These resources are provided to the Government at no cost, other than the minimal cost of postage for resources (approximately £50).   

While there are minimal monetary costs associated with the Government's skin cancer prevention campaigns, there are staff costs of Government employees. Policy officers within Public Health have supported the initiation and implementation of the Sun Safe Schools programme, as have school staff and other colleagues in Children, Young People, Education & Skills (CYPES). Information related to these staff costs is not held in a reportable format. Calculating the time cost associated with these campaigns in financial terms would be very difficult and require a new dataset to be collated. Under the Freedom of Information (Jersey) Law 2011, departments are not required to undertake manipulation or create new data sets to provide a response. Article 3 of the Freedom of Information (Jersey) Law 2011 applies.  

Health and Community Services have invested in Locum Consultants to assist in the Dermatology Department. Though not exclusively contracted to diagnose and operate upon skin cancers, these staff have helped to reduce total numbers of patients awaiting diagnosis and / or treatment by Dermatology. 

The costs associated with Locum staffing for the Dermatology Department across the last five years is as follows:

Additionally, Health and Community Services have also purchased a confocal microscope that will predominantly be used in the detection of skin cancers and management of skin cancer patient cases.

The total costs associated with this are EUR 143,213.00, broken down as follows:

• Equipment EUR 140,613.00
• Installation EUR 2,200.00
• Freight and Carriage EUR 400.00

Articles applied

Article 3 - Meaning of "information held by a public authority"

For the purposes of this Law, information is held by a public authority if –

(a) it is held by the authority, otherwise than on behalf of another person; or

(b) it is held by another person on behalf of the authority

Article 16 - A scheduled public authority may refuse to supply information if cost

excessive

(1)  A scheduled public authority that has been requested to supply information may refuse to supply the information if it estimates that the cost of doing so would exceed an amount determined in the manner prescribed by Regulations.

Article 23 - Information accessible to applicant by other means

(1) Information is absolutely exempt information if it is reasonably available to the applicant, otherwise than under this Law, whether or not free of charge.

(2) A scheduled public authority that refuses an application for information on this ground must make reasonable efforts to inform the applicant where the applicant may obtain the information.