A national survey of elite Australian cricketers reveals elevated self-reported melanoma and keratinocyte cancer rates.
Fresh from Australia’s Ashes triumph over England, elite Australian cricketers are again in the spotlight – this time not for on-field performance, but for their long-term skin health.
A new national survey of current and retired players has identified high self-reported rates of melanoma and keratinocyte cancers across almost all age groups, reinforcing concerns that prolonged ultraviolet radiation exposure in outdoor sport may confer substantial lifetime risk.
The research, published in the Australasian Journal of Dermatology, supports calls to better define high-risk populations as Australia develops a targeted skin cancer screening roadmap.
“There has been very limited study of skin cancer rates in cricketers to date, despite this being a known concern of participants,” the researchers wrote.
“Moreover, there have been no studies of professional cricketers in Australia assessing their lifetime risk of skin cancer despite this being Australia’s leading summer sport.”
The study, conducted in collaboration with the Australian Cricketers Association, invited 1530 current and former elite players to complete an online questionnaire hosted via the University of South Australia.
A total of 451 players responded, representing a 29% response rate. Of these, 39% were female and the median age was 42 years. Participants self-reported prior diagnoses of melanoma, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), along with demographic and sun exposure risk factors.
Self-reported melanoma prevalence increased markedly with age, from 1% in players younger than 30 years to 8% in those aged 51–60 years and 20% in those aged over 70 years.
BCC rates were 1% in the youngest age group, rising to 33% in players aged 51–60 years and 55% in those older than 70. SCC was reported by none of the under-30 cohort, but by 23% of 51 to 60-year-olds and 38% of those over 70 years.
Overall, approximately 30% of respondents reported a history of at least one type of skin cancer.
Very fair or fair-skinned players experienced significantly higher rates of all skin cancers compared with those with medium or dark skin types.
Residence in lower-latitude, sunnier states during adulthood was independently associated with increased risk in multivariate models, whereas childhood residence lost significance after adjustment. Increasing age was the strongest predictor across all cancer types. Female players were less likely than males to report BCC, although no consistent gender differences were observed for melanoma or SCC.
Of those providing anatomical detail, slightly more than half of reported lesions occurred on the head, face or neck, with fewer cancers on the trunk and limbs.
The researchers said this distribution was consistent with cricket-specific exposure patterns, where long-sleeved uniforms may cover the trunk and arms while the face and neck remain exposed during prolonged play between peak ultraviolet hours.
When diagnostic context was described, some participants reported detection through formal screening, while others noted self- or partner-identified lesions prompting medical review, they wrote.
The findings appeared to exceed registry-reported cumulative incidence of invasive melanoma in the general Australian population, particularly among younger age groups.
However, the researchers cautioned that methodological differences preclude direct comparison. Population statistics derived from cancer registry data captured invasive melanoma only, whereas this survey relied on self-report and did not distinguish between invasive melanoma and melanoma in situ.
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Response bias may also have inflated prevalence estimates if players with prior diagnoses were more likely to participate.
Despite widespread reported use of protective behaviours such as sunscreen and hats, these were not independently associated with lower self-reported cancer rates.
The study sits within a broader policy context, as the Australian government funds development of a national targeted skin cancer screening roadmap, “making better definition of high-risk groups an important investigation”, the researchers wrote.
“Currently, one in three middle-aged Australians seek annual skin screening appointments, with concerns regarding overdiagnosis in lower risk segments of the population,” they wrote.
“Documentation of the lifetime risk of skin cancer in elite cricketers (as well as sub-cohorts of players that may be at heightened risk) can help further guide prevention and management amongst this population.”
Screening is not currently recommended for the general population by peak bodies such as the Australasian College of Dermatologists and the Cancer Council Australia due to insufficient evidence of mortality benefit and concerns regarding overdiagnosis.
However, guidance for higher-risk populations is less prescriptive, and elite outdoor athletes may represent a cohort warranting further evaluation in future screening trials.
Australian data in surfers, swimmers and other outdoor athletes have also suggested elevated melanoma prevalence, although comparisons are limited by heterogeneous study designs.
The present study has several limitations, including moderate sample size, potential recall error, and lack of granularity regarding cumulative UV exposure and non-cricket leisure activities.
The 29% response rate introduced possible selection bias, and deceased former players were not captured. Nonetheless, observed associations with age, fair skin type and sunnier adult residence align with established epidemiological risk factors, the researchers noted.
For clinicians caring for elite and retired cricketers, the findings underscore the importance of sustained vigilance. While elite cricketers have been shown in other work to experience lower all-cause mortality than the general population, skin cancer appears to represent a notable exception to the protective association between high physical activity and cancer risk.
“Generally, the advice even for higher-risk groups is to be vigilant and to self-monitor and then to present early if any lesions are noted,” the researchers wrote.
“Retired elite athletes may be amongst suitable populations for any future trials to assess the efficacy of screening as part of developing Australia’s Roadmap towards evidence-based screening. This should include athletes from other outdoor sports such as swimming, surfing, tennis, golf, paddle sports and rowing.”
The researchers concluded that elite cricketers could reasonably be considered to be at increased risk for skin cancer both during and after their professional careers.
“This concern is not unique to cricketers, with similar previous findings in swimmers, surfers and golfers in Australia, baseballers in the USA, and outdoor workers in general across the world,” they concluded.
“Australia itself has high rates of melanoma and keratinocyte cancers in the general population.
“Cricketers should follow the same advice given to all Australians to be vigilant regarding skin health, including regular self-examination and to seek early medical advice regarding changes to any skin lesions.”
