Melanoma, The Color-Blind Killer

I am fair-skinned. I have known for decades that I am especially susceptible to skin damage and disease from exposure to the sun. This has been drummed into me and I recognize that many of my fair-skinned friends are equally at risk. I grew up in Southern California and many of my childhood buddies were of northern European origin. We all baked together at Newport Beach or Zuma Beach in Malibu. Growing up in Los Angeles, I had friends of color, as well. African-Americans, Latinos, Asian, Native Americans: we all grew up together in one, big melting pot. What about them? What about their sun exposure? We all grew up under the same gold orb.

Study across race

According to a recent study in the Journal of the American Academy of Dermatology, non-Hispanic, African Americans had the lowest rates of melanoma diagnoses.¹ Unfortunately they were also most likely to be diagnosed at a later stage.¹ In this study, researchers found that white patients had the longest survival time, followed by Hispanic, Asian American/Native American/Pacific Islander and those of African American heritage.¹ The proportion of later stage melanoma (stage ll-lV) was greater in the African American Community as well.¹

Awareness and information are critical

The researchers concluded that these results suggest that "more emphasis is needed for melanoma screening and awareness in non-white populations to improve survival outcomes."¹ This seems intuitive, but I must admit that I have seen people that are not aware of the sun's danger across all races and ethnicities. More than a few times, I have heard people discourage people of color from using sunscreen or protecting themselves. Typically, it goes something like this, "At least you don't have to worry about getting sun burnt." Not really a helpful comment, is it?

Will this lead to behavioral changes?

Another recent study found racial disparities in the usage of sunscreen.² The research showed that sunscreen usage is "particularly low among certain groups such as men, non-Hispanic blacks, those with less sun-sensitive skin, and those with lower incomes."² The researchers concluded that these demographic groups may benefit from further information about sunscreen usage and how other environmental supports (such as shade in outdoor settings) could provide additional safety from the sun.

Skin cancer and color

People of color are not exempt from melanoma and "actually more susceptible to the least common subtype of the disease, known as acral lentiginous melanoma."³ This is the form of melanoma found on the palms of hands and soles of feet and under nails. These unexpected locations and can be easily missed or ignored. Diligence and information are critical.

Thinking broadly

Lower survival rates and less sunscreen usage among non-whites may have some correlation, but it appears that further research should be done. Rather than speculate particular causes for these differences, I would rather reach some broader conclusions. The sun's rays are damaging to everyone, maybe not to the same degree and in the same way, but UV rays fall on everyone, just like the rain. Everyone should understand this and realize they are at risk and that their behaviors can mitigate these risks.

Sun safety for everyone

No matter who you are, protect yourself from the sun. Natural melanin may provide some protection, but it is still important to think about sun safety and get check-ups. When it comes to sun protection, ignorance is not bliss. Good information and responsible behavior can save lives. Let's all encourage each other in this.