“Risky 6” Amplify Your Likelihood of Deadly Skin Cancer

A new study identifies 6 risk factors for melanoma that you can easily assess for yourself.

March 19, 2009

Painful past: A history of sunburn raises your melanoma risk.

RODALE NEWS, EMMAUS, PA—You wouldn’t know it from all the pink breast cancer awareness ribbons, but skin cancer is the most common of all cancers, according to the American Cancer Society. Some kinds of skin cancer—notably, the basal cell and squamous cell types—aren’t deadly. But melanoma is a different story: In the U.S. alone, one person dies from melanoma every hour. The good news is that with early detection and proper treatment, the cure rate is about 95 percent. And catching it early may have just gotten easier. In a new study presented at this month’s 67th annual meeting of the American Academy of Dermatology (AAD), Darrell Rigel, MD, clinical professor of dermatology at New York University Medical Center in New York City, identified 6 easy-to-understand factors that independently predict melanoma risk.


THE DETAILS: Dr. Rigel pulled data from 600 people, including 300 melanoma patients. From that analysis, he ID’d 6 characteristics, which he says independently predict melanoma risk—and which can be used to assess your own risk level of risk. They are:

1. History of blistering sunburns as a teenager (defined as one or more)
2. Red or blonde hair (natural blondes and redheads have more propensity to burn)
3. Marked freckling of the upper back (defined as the area from the top of the shoulders to the shoulder blades)—it’s a sign of excessive sun exposure and your susceptibility to damage from it
4. Family history of melanoma
5. History of actinic keratoses (scaly lesions produced by excessive exposure to sunlight)
6. Outdoor summer jobs (such as being a lifeguard, housepainter, or camp counselor—any job that required being outdoors all the time) for 3 or more years as a teenager

WHAT IT MEANS: Any one of the six increases your risk of melanoma twofold to threefold over that of the general population. If you have 2 or more risk factors, you have 10 to 20 times the risk of the general population, warns Dr. Rigel. Know your risk, and you know if you have to pay even more attention than most people towards tilting the odds in your favor. “Melanoma is the only cancer that’s increasing in rate, despite all the tools we now have at our disposal to combat it,” points out Dr. Rigel. “That’s why prevention and vigilance are critical—especially if you’re predisposed by your heritage or past sun exposure to developing it.”

Here’s how you can minimize your risk of skin cancer:

• Minimize your exposure. “Skin cancer is a lot like lung cancer—it’s never too late to minimize your sun exposure, just like it’s never too late to stop smoking,” Dr. Rigel says. Stay out of the sun when the sun’s rays are strongest—from 10 am to 2 pm. And slather on sunscreen—a minimum of SPF 30—all the time if you can. “Slowing the rate of exposure is always good,” says Dr. Rigel. “It should be a constant goal.” (Possible downside: Reducing sun exposure can lower your levels of vitamin D. Read our vitamin D topic page to help you decide how you can best balance both concerns. It can be tricky, especially if your melanoma risk is higher than average, so discuss it with your doctor if you’re not sure.)

• Get screened. The AAD is partnering with dermatologists nationwide to offer free skin cancer screenings at certain times of the year (most often in spring). To find out if screenings are offered in your area, head to the AAD website and type your state and city into the Find a Skin Cancer Screening Location search engine.

• See a dermatologist at least once a year for skin checks. Make the appointment on or near your birthday, suggests Dr. Rigel—that way, you’ll always remember it. Don’t have a dermatologist? Find a board-certified one in your area at aad.org.

• Look for danger signs. The AAD advises consulting a dermatologist immediately if any of your moles or pigmented spots exhibit the ABCs of melanoma detection:
A. Asymetry: One half is unlike the other half.
B. Border is irregular, scalloped, or poorly defined.
C. Color varies from one area to another; shades of tan and brown, black; sometimes white, red, or blue.
D. Diameter: Melanomas are usually greater than 6 millimeters—the size of a pencil eraser—though they can be smaller.
E. Evolving: You have a mole or skin lesion that looks different from the rest or is changing in size, shape, or color.