Skin cancer does not discriminate

Skin cancer does not discriminate

For people of color, skin cancer may not be top of mind as a significant health threat. But as I tell my patients in the multi-cultural borough of the Bronx, NY, skin cancer does not discriminate and it impacts all populations regardless of color.

While somewhat rarer in skin of color, skin cancers, including potentially deadly melanoma, do occur and can be quite serious when diagnosis is delayed. In fact, studies consistently show that when compared to Caucasians, people of non-Caucasian heritage are more likely to die from melanoma. An epidemiological review published in the Journal of the American Academy of Dermatology showed that the five-year survival rates for African-Americans (78 percent) is significantly lower than that of Caucasians (92 percent).

Studies also reveal that the incidence of melanoma in the U.S. is increasing in Hispanics. In a recent survey performed at Montefiore Medical Center, less than half of 1,000 adult Hispanic patients surveyed reported that they regularly used sunscreen, wore a hat, or stayed in the shade, despite the fact that they were already under a dermatologist’s care for unrelated skin conditions, such as psoriasis or eczema. One-fourth of the patients surveyed reported seeing ads promoting creams and lotions with sun protection and purchasing those products, yet nearly half still believed people with olive-tone or brown skin cannot get skin cancer and they could not get sunburned on a cloudy day, which is incorrect!

These statistics show that we need to raise awareness about skin cancer risk for people of color. This is particularly important in the U.S. given our rapidly changing national demographics. It is projected that by the year 2050, more than half of our country’s population will be comprised of ethnic minorities.

So what can be done? The answer is simple – we all need to protect our skin from the sun. Ultraviolet radiation remains one of the most important risk factors contributing to the development of skin cancer among all skin types. Ethnicity does not determine skin type/color or immunity to the harmful effects of sunlight.

The good news is when detected early, skin cancer is highly curable. People of all races and ethnic backgrounds should be vigilant about protecting their skin from the sun, avoid artificial sources of UV rays such as tanning beds and seek help with skin lesions that do not heal. I recommend the following to all of my patients:

  1. Use SPF 30 broad-spectrum sunscreen and apply it generously – most people apply only 20-30 percent of what they should.
  2. Use a lip balm with a SPF of at least 30.
  3. Sunscreen alone is not enough to protect you from skin cancer -  seek shade during peak hours (10 AM-4 PM). Wear hats, sunglasses and protective clothing if possible.
  4. Toss your old products – sunscreens have expiration dates! If you question when the product was purchased, dump it.

Bottom line: whether your skin is fair, olive or dark in tone, practice sun safety. It may save your life.

Adam Friedman is director of dermatologic research, Montefiore Medical Center, Bronx, NY.

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  • Suzi Q 38

    Thanks Doctor.
    I have always considered myself a
    “person of color,” even if a few have told me using such a label is not PC. Good article.

    • Kim

      I am a person of color. Pink.

      • ninguem

        That would make you a Person of Pallor.

        • EE Smith

          Racist. ;-)

  • Tim

    more than half of our country’s population will be comprised of ethnic minorities

    I’m pretty sure that if people of color are a majority (“more than half”), then it’s whites who will be the “ethnic minority”.

    • Suzi Q 38

      In California, the whites are the minority.

  • Julia

    Having not read the aforementioned JAAD article, I would doubt the authors overlooked the simple fact confounding the lower five-year survival rates in African-Americans with melanoma. Approximately 60% of all melanomas diagnosed in African-American patients are located on the palms or soles, often of a specific histologic subtype that is prone to risk factors other than solar radiation. Though there certainly is value in increased vigilance regarding sun protection, in populations such as African-Americans and Asian-Americas who are more likely to suffer from non-sun exposure related melanomas, perhaps we should instead advocate for education targeted towards specific ethnic populations and routine skin checks.

    • Suzi Q 38

      I am Asian. Are you saying that the real danger may be located on my feet and palms?

      • Julia

        That is correct. Many studies demonstrate that at least 50% of all melanomas in Asian populations occur on the palms and soles. This isn’t to say that sun protection might reduce your risk of the other subtypes of melanoma — in fact, you should still be vigilant about sunscreen! — but it is certainly worth noting that the melanoma you are most likely to get may not be at all attributed to solar radiation.

        • Suzi Q 38

          Thanks, Julia.

          • Joan Stephens

            I once read the most prevalent place for skin cancer to appear was the back of the knee. Always thought that was odd.

          • Suzi Q 38

            I never would have thought that either.
            I will try to remember that.
            thanks.

  • Anthony D

    I make sure that I have proper sunscreen when I go out in the sun. Thanks for posting Dr. Friedman.

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