Australia has the world's highest skin cancer rates. The keratinocyte cancers (basal cell carcinoma [BCC] and squamous cell carcinoma [SCC]) are the most common and costly, yet unlike melanoma, they are not nationally registered, and the lack of registry data hinders control efforts. The Tasmanian cancer registry collects data on BCC and SCC incidence, revealing concerning trends and high-risk groups. International examples show how registry data inform policy and prevention. Comprehensive registration would enable similar benefits for Australia. We propose a phased approach, starting with high-risk lesions, alongside standardised pathology reporting and the potential use of artificial intelligence, and recommend an evaluation of the cost of this integrated strategy.