The Skin Cancer Foundation Journal

MAY 2015

The 2012 edition of The Skin Cancer Foundation Journal features medically reviewed, reader-friendly articles such as tanning, the increasing incidence of skin cancer diagnoses among young women, & the prevalence of melanoma among white males over 50.

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WHAT IS MY MELANOMA RISK? | WHAT YOU NEED TO KNOW FOR SELF PROTECTION | AMY ROSE, MD "what is my melanoma risk?" ver the past 30 years, awareness about the link between sun exposure and skin cancer risk has substantially grown. How- ever, most people have only a vague under- standing that lying out in the sun or indoor tanning can increase their risk. Less clear to them is how great their risk may be. Most dermatologists encourage everyone to have an annual skin cancer screening, but we know that not everyone has the same baseline risk. This is especially true of melanoma; certain people have substantially higher odds of developing this potentially deadly skin cancer. By targeting them for skin cancer prevention education and frequent skin examination, we have the best chance of detecting and treating melanoma early, when it is most readily curable – or better yet, pre- venting it altogether. So, who exactly is at high risk of melanoma? LIFESTYLE AND ENVIRONMENT VS. INNATE FACTORS Much of melanoma prevention focuses on trying to change behavior – steering people away from ultraviolet (UV) tanning beds, and convincing them to use sun protection daily. However, a considerable part of melanoma risk is out of our control: for example, our age, gender, genetics, ethnic and family background, skin type (including hair and eye color), and the type and quantity of moles we have all can play a significant role. [See Figure 1 on pg. 84 and "Factors That Increase Melanoma Risk" on pg. 85.] INNATE FACTORS In the same way that non-smokers can de- velop lung cancer, patients with minimal sun exposure can develop melanoma. Patients are baffled when a primary melanoma is diagnosed on the buttock, breast, or other places where the "sun doesn't shine." But melanoma cannot always be linked so clearly to UV exposure. Family History: The fact is, melanoma often runs in families. If your mother, father, siblings, or child (first-degree relatives) has had melanoma, you have a 50% greater chance of developing it than people without such a family history. 1 If your grandmother, grandfa- ther, aunt, uncle, niece, or nephew (second- degree relatives) had melanoma, your risk is also increased, though not as great. Anyone in a "melanoma family" should watch very carefully for early warning signs [See pg. 63.] and practice scrupulous sun protection. Ethnic Background: Caucasians account for about 95% of melanoma cases, 2 but people of color are still at risk. In fact, they typically have more advanced cases with poorer out- comes, since they develop more aggressive types of melanoma that show up in more hid den, non-sun-exposed parts of the body. These melanomas are often detected at a later stage. The overall average 5-year melanoma survival rate for African Americans is only 75%, versus 93% for Caucasians. 2 Non-Caucasians may fare worse because of the misconception that they are not at risk for melanoma; they are thus less aware of new or changing moles and neither regularly examine their own skin nor seek professional skin exams. Skin Type: People with fair skin, those with naturally blonde or red hair and many freck- les, and those with blue or hazel eyes are at Melanoma Factor No. 5 ULTRA WHITE SKIN Melanoma Factor No. 4 FRECKLES Melanoma Factor No. 3 LIGHT EYES Melanoma Factor No. 2 RED HAIR Melanoma Factor No. 1 CELTIC ANCESTRY O 83

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