Skin Care & Cancer Awareness

Editorial StaffApril 30, 2020
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Presented by the American Cancer Society

Understanding the damage – and even cancer – that ultraviolet (UV) rays causes skin has evolved that belief, however. While we have learned a lot about the negative effects of indoor and outdoor UV exposure, skin cancer rates in the United States continue to rise.

More than 5.4 million cases of non-melanoma skin cancer will be diagnosed in 3.3 million people in the U.S. this year, in addition to an estimated 100,350 cases of melanoma. Skin cancer will be deadly for some: More than 4,100 people will die of non-melanoma skin cancers, and melanoma will cause an additional 6,850 deaths. In Arizona, melanoma is the fifth most diagnosed type of cancer, affecting an estimated 2,380 people; and nearly 200 people diagnosed will die this year. Arizona ranks 14 in the nation for estimated cases and 11 for deaths related to melanoma in 2020.

A study in the International Journal of Cancer by researchers from the American Cancer Society (ACS) and Harvard University’s T.H. Chan School of Public Medicine in Boston, found 91 percent of all melanomas in the U.S. were linked to UV radiation—mostly due to sun exposure. That rate was even higher among non-Hispanic whites at 94 percent.

While indoor tanning rates are declining, there is a long road ahead. Only 19 states and the District of Columbia have laws that ban the use of indoor tanning devices for people under 18. Arizona is among 27 states to have some restrictions, and pending legislation to prevent teenagers from using tanning devices.

Key Findings

The incidence rate of melanoma due to UV radiation was considerably high in all states.

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Several factors can contribute to the risk of melanoma, including the use of sun protection, the UV Index, and the use of indoor tanning facilities.

Proximity to the equator and altitude are key factors when determining UV Index impact.

25 percent of women 18 to 21 years old reported regular visits to indoor tanning beds.

Types of Skin Cancer

The skin is the largest organ of the human body. There are three main types of cells in the top layer of the skin, the epidermis:

Squamous Cells These are in the outer part of the epidermis and shed as new cells form.

Basal Cells These are in the lower part of the epidermis, and constantly divide to form new cells to replace the squamous cells that wear off the skin’s surface.

Melanocytes These cells make the brown pigment called melanin, which gives skin its color. Melanin acts as the body’s natural sunscreen, protecting deeper layers of skin from some of the harmful effects of the sun. For most people, when skin is exposed to the sun, melanocytes make more of the pigment, causing the skin to tan or darken.

The epidermis is separated from the deeper layers of skin. When a skin cancer becomes advanced, it generally grows deeper. Most skin cancers are non-melanoma and develop on sun-exposed areas of the body. They can grow slowly or quickly, but they rarely spread. Most are basal cell or squamous cell, and are less likely to be deadly. Melanoma is less common, but can be much more serious. If detected early, melanoma is usually curable, but it can spread to other parts of the body. Once melanoma cells reach vital organs and grow, they are harder to treat and less curable.

Basal Cell Carcinoma

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Basal cell carcinomas are the most common type of skin cancer and the most common cancer in humans. Approximately 8 out of 10 skin cancers are basal cell carcinomas. They form in the lowest level of the epidermis and tend to grow slowly. It’s rare for basal cell carcinoma to spread. If it is not completely removed, it can recur. People diagnosed with basal cell carcinomas are also more likely to get new skin cancers in
other places.

Squamous Cell Carcinoma

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Squamous cell carcinomas are not as common, but they still account for about 2 out of 10 skin cancers. They form in the outer layers of the skin and can grow deeper and spread to other parts of the body, although that is rare.

Melanoma

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Melanoma starts in the melanocytes and can form anywhere on the body. They are most likely to form on the chest and back in men, and on the legs in women. Other common areas: face and neck. Melanoma may start without warning, or it may start in or near moles and dark skin spots. These cells can still make melanin, which is why these cancers can have mixed shades of brown, tan, black, and even blue.

Who is at risk?

Gender Men are more likely than women to have basal cell cancers and squamous cell cancers of the skin.

Age The rate of skin cancers increases with age. Skin cancers are becoming more common in younger people, probably because they are spending more time in the sun with skin exposed.

Family History Melanoma runs in some families, and the risk is greater if one or more of a person’s first-degree relatives has been diagnosed. This may be due to a family lifestyle of frequent sun exposure, having fair skin, inheriting a gene mutation, or a combination of factors.

Race Because most skin cancers are caused by overexposure to UV radiation, everyone is at risk. Whites with fair skin that freckles or burns easily are at especially high risk. The lifetime risk of melanoma is higher for whites than for African Americans because of the protective effect of skin pigment, but no one is safe from developing skin cancer.

Immune System Suppression People with weakened immune systems have increased risk.

Ultraviolet Radiation & Sunburn People with excessive exposure to tanning booths or sunlight are at greater risk. If a person has had severe, blistering sunburns, especially in their childhood or teenage years, they also have an increased chance of developing skin cancers later in life.

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Moles People with many moles (especially large or irregular ones) have an increased risk for melanoma.

How to prevent skin cancer?

The best way to lower the risk of skin cancer is to limit unprotected exposure to the sun, and never use tanning beds or sun lamps. When in the sun, the American Cancer Society recommends the “Slip! Slop! Slap! And Wrap!” method to help prevent sun damage that could lead to skin cancers:

Slip! on a shirt Clothing can provide different levels of UV protection. Long-sleeved shirts, long pants or skirts, tightly woven fabric, and darker fabrics provide the most protection. Dry fabric is generally more protective than wet , though some companies make clothing that is lightweight, comfortable, and protects against UV exposure even when wet.

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Slop! on a broad-spectrum sunscreen of SPF 30 or higher.  Use of sunscreens with broad spectrum protection against UVA and UVB rays and with sun protection factor (SPF) values of 30 or higher are recommended. Apply liberally and often, paying close attention to exposed areas like the face, neck, ears, and backs of hands. Don’t forget a lip balm with sunscreen. Sunscreen doesn’t provide total protection from UV rays, but it helps.

Slap! on a hat Hats with at least a 2- to 3-inch brim all around are ideal. They protect areas often exposed to sun: ears, eyes, forehead, nose, and scalp. A dark, non-reflective underside to the brim can help lower the amount of UV rays reaching the face from reflective surfaces such as water. Shade caps (which look like baseball caps with about 7 inches of fabric draping down the sides and back) provide more protection for the neck. Straw hats are not as protective as ones made of tightly woven fabric.

Wrap! on sunglasses Sunglasses are important for protecting eyes and the delicate skin around them. Look for wrap-around sunglasses with at least a 99 percent UV absorption rate for the most protection.

How to detect skin cancer?

Unlike other cancers, skin cancer doesn’t require any invasive or elaborate tests to detect. You can use your eyes and a mirror, but it helps to know what to look for. Skin cancers can be easily recognized during monthly self-exams and routine check-ups. Knowing your own pattern of freckles, moles, blemishes, birthmarks, and other marks is important to monitor changes. Non-melanoma cancers can look like a variety of marks. Warning signs include new growths, a spot that grows, or a visible sore that doesn’t heal within several weeks.

To spot a melanoma, the ABCDE rule is an easy guide

A for ASYMMETRY: If one half of a mole or birthmark is different from the other half.

B for BORDER: If the edges of a spot on the skin are irregular, ragged, notched, or blurred.

C for COLOR: If the color is not the same throughout and has different shades of brown or tan, or includes black, red, white, pink, and even blue.

D for DIAMETER: Most moles are less than ¼-inch across. If a mole is larger (about the size of a pencil eraser) or is growing larger.

E for EVOLVING: Once a mole has developed, it normally stays the same size, shape, and color. Most moles fade as you age. Any changes to the mole should be checked by a health provider.

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How to treat skin cancer?

Most non-melanoma skin cancers may be cured by minor surgery, usually simple excision, but other treatments may be used: lasers, heat, cold, radiation and chemotherapy, depending on where and how large the tumor is. If detected early, melanoma may be treated successfully with surgical excision, although additional surgery to test and, if necessary, remove surrounding tissue may be needed. If the cancer has spread, more extensive surgery and treatment will be needed. The survival rate for skin cancer is high. The five-year localized survival rate for melanoma is 98 percent. If it has spread to other parts of the body, that rate falls to 20 percent. Early diagnosis
is imperative.

What’s the bottom line?

Most skin cancers could be prevented by limiting unprotected exposure to the sun, practicing Slip! Slop! Slap! And Wrap!, knowing what to look for during self-skin exams and reporting changes to a physician. Most skin cancers can be treated successfully if detected early – even melanoma.

What ACS is doing to fight Skin Cancer?

The American Cancer Society provides free cancer information 24 hours a day, 365 days a year through our National Cancer Information Center at 1-800-227-2345 or on our web site at cancer.org.

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