People of Color and Early Skin Cancer Detection

March 7, 2016

While Caucasians are predominantly the victims of skin cancer, everyone, no matter what color skin they have, can develop it. All too often, people of color are diagnosed with skin cancer at later stages. Delays can mean the condition is potentially advanced or even fatal, although most are curable if detected and treated right away.

Melanin, the pigment that gives skin and eyes their color, is produced in the outermost layer of the skin called the epidermis. The more melanin produced, the darker the skin pigmentation. Melanin helps protect the skin against the effects of the sun’s ultraviolet rays (UVR) such as skin cancers and premature aging.

Melanin provides a sun protection factor (SPF) in African American skin that is about 13.4 compared to 3.4 in white skin. This difference shows why skin cancer is more prevalent in Caucasian people than people of color; it is, in fact, the most common type of malignancy in the U.S. among Caucasians. Light skin color and low amounts of melanin combine to create vulnerability to the sun’s carcinogenic (cancer-causing) ultraviolet rays. UV light from tanning beds is also a cause of skin cancer in Caucasian Americans.

Although skin cancer encompasses only 2% to 4% of all cancers in Chinese and Japanese Asians, the frequency is increasing. Also, it accounts for 1% to 2% of malignancies in African Americans and Asian Indians. Sadly, mortality rates remain disproportionately high in people of color, especially those with darker skin.

The five-year survival rate for African Americans is 73%, compared with 91% for Caucasians, according to the American Academy of Dermatology. That variance is probably due to later diagnosis and treatment.

When an initial melanoma diagnosis is made after the disease is at an advanced stage, the chances of a cure are diminished by an estimated 52% for non-Hispanic blacks and 26% for Hispanics, compared with 6% for non-Hispanic whites, according to the Skin Cancer Foundation, a public education and research organization.

Malignant ALM (also called subungual melanoma) affects people of Asian or African descent more than any other race or ethnicity. The average patient is between 60 and 70 years of age, but ALM can affect people of any age. This classification of the disease is generally found on the hands, feet and other areas of the body where very little hair grows. Presently, sunlight is not a proven cause of this condition.

Although fewer people of color actually get skin cancer, the death rate is higher than for light-skinned people (who are at greater risk). Increasing awareness of the importance of sunscreen and routine skin checks for people of all skin types is an important part of prevention.

Although dark skin is naturally more protective against harmful rays from the sun than fair skin, people of all skin types can burn if they don’t wear sunscreen. The burn may not be as obvious on dark skin, but this does not mean it is harmless. It is important for everyone to take preventative measures against sunburn. No one should think they are immune to sunburns and skin cancer, no matter what the color of their skin.

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