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Skin cancer: Know your risk

My Skin MagazineRandallAnthony CommunicationsComment

By Dr. Jason K. Rivers

It’s only skin deep, but melanoma is a potentially deadly spot caused by exposure to ultraviolet light from either the sun or artificial light sources. There will be 6,000 new cases of melanoma in Canada this year, and another 1,050 people are predicted to die from this cancer. In North America, someone dies from melanoma every hour.  

This malignancy does not affect everyone equally, and certain risk factors increase your likelihood of developing melanoma. Fair-skinned individuals with freckles and blond or red hair – who tend to burn easily and rarely tan – are at heightened risk. So too are those who have a large number of common and atypical-appearing moles (also known as melanocytic nevi) or who have one or more relatives with melanoma. Your risk also increases if you’ve had a non-melanoma skin cancer, such as basal cell carcinoma or squamous cell carcinoma.

Given that ultraviolet radiation plays a pivotal role in the genesis of melanoma, it should come as no surprise that having had outdoor summer jobs for three or more years as a teenager or regularly using tanning beds predisposes one to melanoma. Tanning bed use has proliferated across Canada and the United States in the past 20 years, and although they are marketed as a safe way to develop a protective tan, there is nothing safe about tanning beds. In fact, using a tanning bed can increase your risk for melanoma by 20 per cent, and that risk may be increased by 87 per cent if tanning started before age 35. In Australia, it has been suggested that up to 75 per cent of all melanomas occurring in those younger than 30 are attributable to tanning bed use. 

Although you might think you have a reduced risk of developing melanoma if you have darker skin or tan easily, this is only partly true. The incidence of melanoma in people of colour is much less than it is for those with a lighter skin complexion, but darker-skinned individuals are certainly not immune. 

In fact, the rate of melanoma is rising quite dramatically in North America’s Hispanic population. While melanoma is uncommon in the Asian population, the disease may manifest in areas not always considered for melanoma, such as on the palms or soles or under a fingernail (where it appears in adults as a changing or new pigmented band). Although it is also uncommon in the African-Canadian population, melanoma may be a more aggressive tumour in this group.

Remember, regardless of your skin colour, everyone can develop this malignancy. The key to treating melanoma is early diagnosis – when you identify it in its early stages, it remains just a spot and one that will cause no harm.  

Dr. Jason K. Rivers, MD, FRCPC, FAAD, is a clinical professor of dermatology and a past director of the dermatology residency training program at the University of British Columbia. He currently practices medical and cosmetic dermatology at Pacific Dermaesthetics in Vancouver, BC, and is the developer and founder of Riversol Skin Care. 

How bad is it?

The Fitzpatrick Scale is used to determine sensitivity to ultraviolet light exposure based on skin colour:

Type I: Pale white:

Always burns, never tans

Type II: White:

Usually burns, tans minimally

Type III: Cream white:

Sometimes will develop a mild burn, tans uniformly

Type IV: Moderate brown:

Rarely burns, tans well

Type V: Dark brown:

Very rarely burns, tans very easily

Type VI: Dark brown to black:

Never burns, tans extremely well

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