While people of color have a lower risk of developing skin cancer than Caucasians, they are not immune to the disease. In fact, skin cancer is often diagnosed at a more advanced stage in people of color, which can make it more difficult to treat. A new study provides recommendations for the prevention and early detection of skin cancer in people of color based on a comprehensive review of available data.
In the report entitled, "Skin cancer and photoprotection in people of color: A review and recommendations for physicians and the public," published online in the Journal of the American Academy of Dermatology, a workgroup of recognized skin of color experts provided an extensive review of the scientific literature available on the incidence, risk factors and characteristics of skin cancer in people of color.
On average, one American dies from melanoma, the deadliest form of skin cancer, every hour. The five-year survival rate for African Americans and Latinos diagnosed with melanoma is lower than Caucasians, likely due to the fact that it is often more advanced when diagnosed. For example, the five-year survival rate for African Americans is 73 percent compared to 91 percent in Caucasians.
"Many people of color mistakenly believe that they are not at risk, but skin cancer is color blind," said board-certified dermatologist Henry W. Lim, MD, FAAD, C.S. Livingood Chair and chairman of the department of dermatology at Henry Ford Hospital in Detroit, Mich. "When detected early, skin cancer is highly treatable, but it can pose a serious health threat if left untreated."
Recommendations for preventing skin cancer
Unprotected exposure to ultraviolet (UV) rays has been identified as a risk factor for skin cancer in people of color. Basal cell carcinoma, the most commonly diagnosed skin in cancer in Asian Americans and Latinos, is most frequently found on sun-exposed areas of the skin, such as the head and neck.
Based on this information, the study authors recommend everyone, including people of color, take the following steps to prevent skin cancer:
• Seek shade whenever possible.
• Wear sun-protective clothing, including a wide-brimmed hat and sunglasses.
• Stay out of tanning beds.
• Apply sunscreen with a sun protection factor (SPF) of at least 30 to all exposed areas of the skin 15 to 30 minutes before going outdoors. When outdoors, reapply sunscreen every two hours, and after swimming or sweating.
It is also recommended that people of color take a vitamin D supplement because they are at a higher risk of vitamin D deficiency, especially individuals with darker skin.
Recommendations for detecting skin cancer
When skin cancer is diagnosed in people of color, it is often found in areas of the skin that are not typically exposed to the sun. Specifically, the bottom of the foot is where 30 to 40 percent of melanomas are diagnosed in people of color. Nearly eight percent of melanomas in Asian Americans occur in the mouth. Squamous cell carcinoma, the most commonly diagnosed skin cancer in African Americans, often develops on the buttocks, hip, legs, and feet.
Based on this information, the study authors recommend people of color take the following steps to prevent skin cancer:
• On a monthly basis, perform a thorough skin self-exam. • Pay special attention to the palms of the hands, soles of the feet, the fingernails, toenails, mouth, groin and buttocks. • Look for any spots or lesions that are changing, itching, or bleeding or any ulcers or wounds that won't heal.
"Skin cancer can look and develop differently in individuals with skin of color than it does in individuals with lighter skin," said Dr. Lim. "That's why it's so important for everyone to check their skin regularly and make an appointment to see a board-certified dermatologist if you see anything suspicious."
- Oma N. Agbai, Kesha Buster, Miguel Sanchez, Claudia Hernandez, Roopal V. Kundu, Melvin Chiu, Wendy E. Roberts, Zoe D. Draelos, Reva Bhushan, Susan C. Taylor, Henry W. Lim. Skin cancer and photoprotection in people of color: A review and recommendations for physicians and the public. Journal of the American Academy of Dermatology, 2014; DOI: 10.1016/j.jaad.2013.11.038
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