# A Narrative Review of European Registries for Skin Cancer: Where Are We and Where Should We Be?

## TL;DR

European cancer registries track melanoma well but miss many non-melanoma skin cancers, leading to an underestimation of their true burden.

## Contribution

The paper identifies gaps in non-melanoma skin cancer registration and proposes practical steps to improve data quality and harmonization across Europe.

## Key findings

- Melanoma incidence has risen for decades but is plateauing in younger age groups.
- Non-melanoma skin cancer registration is inconsistent, leading to substantial underestimation of its true burden.
- Only 538 European skin cancer registry-based publications were identified between 2015 and 2025.

## Abstract

Skin cancer is the most common cancer in fair-skinned populations. Melanoma is routinely captured by European cancer registries, but non-melanoma skin cancers (NMSCs)—especially basal cell carcinoma—are inconsistently recorded or even omitted. This narrative review summarizes where European registries currently stand and where they should go. We describe coverage and data quality, show current melanoma incidence levels and trends, and assess how registry data are used in research. Melanoma incidence has risen for decades but appears to plateau in younger cohorts, while the true NMSC burden is substantially underestimated because of incomplete registration. We outline practical steps to improve completeness (e.g., including outpatient and pathology data), timeliness, and harmonization, and propose sentinel regions for robust NMSC estimates. Better, faster, and more comparable registry data are essential to guide prevention, service planning, and policy in Europe.

Background: European population-based cancer registries (PBCRs) provide the foundation for monitoring skin cancer, yet registration practices and coverage vary, particularly for non-melanoma skin cancer (NMSC). Methods: We conducted a narrative review combining descriptive analyses of European Cancer Information System (ECIS) outputs with evidence from the European Network of Cancer Registries (ENCR) Working Group on NMSC and from national reports. A targeted PubMed search (2015–2025) assessed scientific usage of European registry data. Results: Nearly 200 PBCRs operate across about 40 European countries, with heterogeneous structures and timeliness. The ECIS estimated 101,500 incident cutaneous melanomas (CM) in the European Union in 2022. Long-term data from Nordic countries show a tenfold increase in CM incidence over the last six decades, with recent plateauing in younger cohorts. NMSC registration remains inconsistent: some countries record both cutaneous squamous cell carcinoma (cSCC) and basal cell carcinoma (BCC), others record cSCC only, and several omit NMSC entirely. Consequently, Europe-wide NMSC figures are not available from the ECIS. Global estimates exclude BCC and understate the true burden, which is likely between 1 and 1.6 million incident cases annually in Europe. The PubMed search identified 538 European registry-based publications on skin cancer (2015–2025). Conclusions: Melanoma registration in Europe is robust, but NMSC remains under-registered. Priorities include harmonized definitions and counting rules, better integration of outpatient and pathology data, streamlined EU-level reporting, digital/AI-enabled case ascertainment, and sentinel regions to generate reliable NMSC estimates.