Skin Cancer

Skin Aging

-An estimated 90 percent of skin aging is caused by the sun. -People who use sunscreen with an SPF of 15 or higher daily show 24 percent less skin aging than those who do not use sunscreen daily. -Sun damage is cumulative. Only about 23 percent of lifetime exposure occurs by age 18.

Recognizing Melanoma

-Asymmetry -Borders -Color -Diameter -Evolution/Elevation

Fitzpatrick skin types

-Created in 1975 for predicting skin reactivity in PUVA photochemotherapy. -Used world wide to estimate the risk of skin cancer (basal cell carcinoma (BCC) and cutaneous malignant melanoma (CMM) ). -This self-reported skin type is determined by the use of a questionnaire, where the person grades his/her tendency to burn and ability to tan respectively 24 hours and 7 days after the first un-protected sun-exposure in the early summer. -There are four possible answers for "white"-skinned persons (skin type I, II, III, IV). Brown skin is classified as skin type V and black skin as skin type VI

Statistics

-Each year in the U.S. over 5.4 million cases of nonmelanoma skin cancer are treated in more than 3.3 million people. -Each year there are more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon. -Over the past three decades, more people have had skin cancer than all other cancers combined. -One in five Americans will develop skin cancer in the course of a lifetime. -Between 40 and 50 percent of Americans who live to age 65 will have either basal cell carcinoma or squamous cell carcinoma at least once. -Basal cell carcinoma (BCC) is the most common form of skin cancer. More than 4 million cases are diagnosed in the U.S. each year. -Squamous cell carcinoma is the second most common form of skin cancer. More than 1 million cases are diagnosed in the U.S. each year. -Organ transplant patients are approximately 100 times more likely than the general public to develop squamous cell carcinoma. -Actinic keratosis is the most common precancer; it affects more than 58 million Americans. -About 90 percent of nonmelanoma skin cancers are associated with exposure to ultraviolet (UV) radiation from the sun. -The annual cost of treating skin cancers in the U.S. is estimated at $8.1 billion: about $4.8 billion for nonmelanoma skin cancers and $3.3 billion for melanoma.

Men/Women

-From ages 15-39, men are 55 percent more likely to die of melanoma than women in the same age group. -An estimated 52,170 new cases of invasive melanoma in men and 34,940 in women will be diagnosed in the U.S. in 2017. -An estimated 6,380 men and 3,350 women in the U.S. will die from melanoma in 2017. -Women aged 49 and under have a higher probability of developing melanoma than any other cancer except breast and thyroid cancers. -Up until age 49, significantly more white women develop melanoma than white men (1 in 155 women vs. 1 in 220 men). From age 50 on, significantly more men develop melanoma than women. Overall, one in 28 white men and one in 44 white women will develop melanoma in their lifetimes. -The majority of people diagnosed with melanoma are white men over age 55.

Pediatrics

-Melanoma accounts for up to three percent of all pediatric cancers. -The treatment of childhood melanoma is often delayed due to misdiagnosis of pigmented lesions, which occurs up to 40 percent of the time.

Melanoma Statistics

-One person dies of melanoma every hour (every 54 minutes). -An estimated 87,110 new cases of invasive melanoma will be diagnosed in the U.S. in 2017. -An estimated 9,730 people will die of melanoma in 2017. -Melanoma accounts for less than one percent of skin cancer cases, but the vast majority of skin cancer deaths. The vast majority of melanomas are caused by the sun. In fact, one UK study found that about 86 percent of melanomas can be attributed to exposure to ultraviolet (UV) radiation from the sun. -The estimated 5-year survival rate for patients whose melanoma is detected early is about 98 percent in the U.S. The survival rate falls to 62 percent when the disease reaches the lymph nodes, and 18 percent when the disease metastasizes to distant organs. -On average, a person's risk for melanoma doubles if he or she has had more than five sunburns. -Regular daily use of an SPF 15 or higher sunscreen reduces the risk of developing squamous cell carcinoma by about 40 percent and the risk of developing melanoma by 50 percent.

Protection

-Sunscreen -Hat -Clothes -Sunglasses -Shade

Ethnicity

-The estimated 5-year melanoma survival rate for blacks is only 69 percent, versus 93 percent for whites. -Skin cancer represents approximately two to four percent of all cancers in Asians. -Skin cancer comprises one to two percent of all cancers in blacks and Asian Indians. -Melanomas in blacks, Asians, Filipinos, Indonesians, and native Hawaiians most often occur on non-exposed skin with less pigment, with up to 60-75 percent of tumors arising on the palms, soles, mucous membranes and nail regions. -Basal cell carcinoma is the most common cancer in Caucasians, Hispanics, Chinese Asians and the Japanese. -Squamous cell carcinoma is the most common skin cancer among blacks and Asian Indians. -Squamous cell carcinomas in blacks tend to be more aggressive and are associated with a 20-40 percent risk of metastasis (spreading). -Late-stage melanoma diagnoses are more prevalent among minority patients than Caucasian patients; 52 percent of non-Hispanic black patients and 26 percent of Hispanic patients receive an initial diagnosis of advanced stage melanoma, versus 16 percent of non-Hispanic white patients.

Skin Type Score - Fitzpatrick Skin Types

-Type 1: Highly sensitive, always burns, never tans -Type 2: Very sensitive, burns easily, tans minimally -Type 3: Sensitive, sometimes burns, slowly tans to light brown -Type 4: Minimally sensitive, burns minimally, always tans to moderate brown -Type 5: Insensitive, rarely burns, tans well -Type 6: Insensitive, never burns, deeply pigmented

Tanning

-Ultraviolet (UV) radiation is a proven human carcinogen. -The International Agency for Research on Cancer, an affiliate of the World Health Organization, includes ultraviolet (UV) tanning devices in its Group 1, a list of agents that are cancer-causing to humans. Group 1 also includes agents such as plutonium, cigarettes and solar UV radiation. -As of September 2, 2014, ultraviolet (UV) tanning devices were reclassified by the FDA from Class I (low risk), to Class II (moderate risk) devices. -Twelve states plus the District of Columbia prohibit people younger than 18 from using indoor tanning devices: California, Delaware, Hawaii, Illinois, Louisiana, Massachusetts, Minnesota, Nevada, New Hampshire, North Carolina, Texas and Vermont. Oregon and Washington prohibit those under 18 from using indoor tanning devices, unless a prescription is provided -Brazil and Australia have banned indoor tanning altogether. Austria, Belgium, Finland, France, Germany, Iceland, Italy, Norway, Portugal, Spain and the United Kingdom have banned indoor tanning for people younger than age 18. -More than 419,000 cases of skin cancer in the U.S. each year are linked to indoor tanning, including about 245,000 basal cell carcinomas, 168,000 squamous cell carcinomas, and 6,200 melanomas. -More people develop skin cancer because of tanning than develop lung cancer because of smoking. -Those who have ever tanned indoors have a 67 percent increased risk of developing squamous cell carcinoma and a 29 percent increased risk of developing basal cell carcinoma. -Those who have ever tanned indoors have a 69 percent risk of developing basal cell carcinoma before age 40. -Individuals who have used tanning beds 10 or more times in their lives have a 34 percent increased risk of developing melanoma compared to those who have never used tanning beds. -People who first use a tanning bed before age 35 increase their risk for melanoma by 75 percent.