Progress in skin cancer: the U.K. experience

When celebrating the 125‐year anniversary of the British Journal of Dermatology (BJD), we are highlighting its long and distinguished record in publishing on skin cancer, covering many topics from skin cancer epidemiology to the basic molecular mechanisms of carcinogenesis. Skin cancer prevention and treatment are frequently addressed, and the publication and maintenance of well‐considered national and international treatment guidelines are of particular value to the hard‐pressed clinician. A number of questions remain to be answered. The incidence of skin cancer has been increasing steadily in fair‐skinned individuals since the mid‐twentieth century, particularly for nonmelanoma (keratinocyte) skin cancers (NMSCs), basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), as well as melanoma. Dermatology services in the U.K. are increasingly stressed by this rise, which is resulting from an ageing population and increasing recreational sun exposure. Use of hospital episode statistics suggested that the cost of skin cancer treatment was in the range of £106–£112 million in 2008, but a rise to at least £180 million was predicted for 2020.1 With a shortage of consultants in rural and remote areas in the U.K., dealing with this increase means we have to rethink the pattern of skin cancer services. New proposals centre around the introduction of high‐volume, consultant‐led intermediary care services being able to provide treatments for uncomplicated skin cancers, or the development of specialty doctor‐led skin cancer clinics.