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

<b>Background</b>: 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). <b>Methods</b>: 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. <b>Results</b>: 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). <b>Conclusions</b>: 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.