Special Populations Affected
Reviewed by: HU Medical Review Board | Last reviewed: May 2017.
The appearance and location of skin cancer can vary in different populations. Risk factors and outcomes differ, too. In particular, there are unique considerations for older white men, younger white women, people with darker skin tones, and children. Importantly, sun protection reduces skin cancer risk for everyone.
Skin cancer hits white men older than 50 harder than anyone else. Per 100,000 white men of all ages, there are 33.5 new cases of melanoma.1 The incidence (number of new cases per 100,000) is 51 at age 65 and rises to 67.4 by age 80.2 Approximately twice as many men die of melanoma than women, and the death rate rises dramatically with age.1,2 One in 28 white men will develop melanoma during his lifetime.3 The probability of developing non-melanoma skin cancer is even higher.
Historically, outdoor work lead to long-term sun exposure for many men. Chronic sun exposure is an especially strong risk factor for squamous cell carcinoma. Sunburns increase the risk of melanoma 2.5-fold in men.4
Women under 50
The number of new cases of skin cancer is has increased dramatically in young and middle-age white women.5,6 Compared with 1970, cases of melanoma have increased 8-fold in women under 40.5. For women age 40 to 60, there has been a 24-fold increase in melanoma.6 Today, per 100,000 white women, there are 18 new cases of melanoma among 35- to 39-year olds, and 28 new cases among 45- to 49-year olds.2
Some of the increase may be due to more awareness. But use of tanning beds probably has been a bigger factor. Indoor tanning is a strong risk factor for skin cancer in young women.
Children and young adults
Sun protection is particularly important during the early years. Not only is this the time when habits form, but childhood sun exposure is a risk factor for later skin cancer.7 Young children are susceptible to ultraviolet (UV) damage because they produce less melanin. Their topmost layer of skin, the first line of defense against the sun, is very thin.
Teens may abandon sun-protective behaviors in favor of getting a tan. Sunscreen use drops between ages 9 and 15.7 More than 75% of white teenage girls get a sunburn and 15% report indoor tanning.8 Indoor tanning has been blamed—in part—for the rise of melanoma among young women.
People with dark skin tones
Skin cancer is less common in people with dark skin tones than it is in whites, but can be more dangerous. UV radiation damages skin of all shades.9 Non-UV risk factors also play a role in skin cancer in people with dark skin tones.
When examining a lesion, doctors may be less likely to suspect skin cancer in a person with dark skin tones.9 Cancers on non-sun exposed skin are more common in people with dark skin tones. Lesions that look pink or colorless in white people may be pigmented (dark) in people with darker skin.
Delays in diagnosis mean that the cancer is often found at a later stage in people with dark skin tones. For example, melanoma is localized at diagnosis for 80% of whites and 54% of blacks.10 Conversely, 4% of whites and 13% of blacks with melanoma are diagnosed with distant metastasis.10 For this—and other reasons—5-year overall survival rates are lower in other races/ethnicities than whites: 78.2% (blacks), 87% (Hispanics), 80.7% (Asians), and 90% (whites).10