Racial Differences in Skin Cancer

Cancer development, treatment, and outcomes are tricky topics to understand. The underlying reasons why a person gets cancer or how they might respond to treatment are often unknown and depend on a variety of factors. Just as we can study different risk factors and treatments, we can study different characteristics of people with cancer. Learning more about the individuals getting cancer and their overall outcomes can help us develop new treatments and better identify those at risk.

Many different cancer characteristics have been studied in recent years. However, there has been a growing interest in learning more about race and ethnicity in relation to skin cancer. In honor of Minority Cancer Awareness Month, interesting findings from a few studies on the topic are below.

Who is getting skin cancer?

Overall, the risk of getting melanoma and non-melanoma skin cancers is the highest for White people. However, melanoma diagnoses are on the rise in Latino people, and this group is currently at a higher risk of developing melanoma than Black people.^1,2

Differences in diagnosis and outcomes

Although minority groups may be at a lower risk of developing skin cancer, they are disproportionately affected by worse outcomes and diagnoses. Overall:

• Black and Latino people are more likely to die than White people for all skin cancers.
• When it comes to melanoma specifically, Black people are more likely to be diagnosed at later stages or with distant metastasis when compared to White people.
• One study found that 91 percent of White people are diagnosed with earlier stage melanoma, compared to 74 percent and 48 percent of Latino and Black people, respectively.^1,2

Melanoma

Black people are also more likely to be diagnosed with acral lentiginous melanoma (ALM) which has a worse 5-year survival rate than the most common types of melanoma found in White people. Latino people also have a higher risk of getting ALM than White people. ALM can be hard to diagnose early, as it does not follow the normal growth pattern of melanoma. It can be found on the hands, soles of the feet, and in the nail beds. ALM may be mistaken for a bruise or not be seen at all if it is on the bottom of the foot. This makes it hard to diagnose early.¹

Melanoma in Latino people may be diagnosed at younger ages and present with thicker tumors. These cases of melanoma are more likely to have already started to spread or metastasize at the time of diagnosis. This may be one of the reasons why Latino people have a worse overall survival from melanoma than White people, despite being less affected by it.² Overall survival time from melanoma is longest for White people, followed by Latino people and Asian and Pacific Islanders. Black people have the shortest overall survival times.³

Non-melanoma skin cancers

Non-melanoma skin cancers also show racial and ethnic differences in diagnosis, too:

• Basal cell carcinoma (BCC) is the most common in Latino and White people.
• Squamous cell carcinoma (SCC) is more common (and aggressive) in Black people.
• Asian people may have variations based on their ancestry or country of origin. Those of Chinese and Japanese heritage may be more likely to have BCC. People of Asian Indian heritage may be more likely to have SCC.²

Varying attitudes regarding skin cancer

Different understandings of skin cancer and risk in minority groups may contribute to the later, more aggressive, diagnoses. For example, in one Florida-based study, researchers found that:

• Only a quarter of minorities at a health clinic had heard of skin cancer.
• About 20 percent thought their darker skin meant they could not get skin cancer.
• Just under half thought it was unlikely or very unlikely to get skin cancer.
• Around 60 percent had never done a self-skin check and only about 20 percent had ever seen a dermatologist.⁴

Although minorities are at a lower risk of skin cancer, it is still possible. Results like these show the importance of monitoring for signs of skin cancer to prevent delays in diagnosis. Education and awareness of skin cancer across all skin types may be key to reducing disparities.

What does it all mean?

Overall, these results suggest that there are differences in cancer development, understanding, and prognosis of skin cancer between racial and ethnic groups. The reasons for this are not well understood and may be related to a variety of different factors. Some of these may be related to genetics, environmental or work exposures, social factors, financial issues, lifestyle practices, diet, access to healthcare and helpful resources, and more.

This is such an important topic to talk about, as more aggressive cancers and high mortality rates can take a huge toll on quality of life. However, this information is only from a few studies, and much more research is needed to understand the factors at play. For the time being, studies like these can help call out the differences in general, and may help doctors better diagnose and treat people from all backgrounds.

Resources for minority groups with skin cancer

This information may seem overwhelming and confusing, especially for individuals belonging to minority groups that appear to have worse outcomes. It is okay to ask for help and support as you navigate your journey.

While some large organizations have resources designed for everyone living with skin cancer, there are some minority-specific organizations that can help as well. Several resources to consider if you or a loved one with skin cancer belongs to a minority group include the following:

• Black Women’s Health Imperative: Provides health-related support to black women and girls.
• Latinas Contra Cancer: Provides health education and support group services to Spanish-speaking women.
• Malecare: Supports male cancer survivors, including underserved populations, like minority men with cancer.
• National LGBT Cancer Network: Supports LGBT cancer survivors through training, education, and support groups.