It is a misconception that people with more melatonin in their skin (people of colour) are immune to the harmful UV rays from the sun. In fact, skin cancer affects people of all races and skin tones and although people of colour are less at risk, they are much more likely to die from it due to a delay in detection or presentation. For this reason, and because more than 90 % of skin cancers are preventable, it is important to detect skin cancer early, especially in people of colour.

Types of skin cancer in people of colour

Skin cancers are divided into two main groups – melanoma and non-melanoma skin cancer (NMSC), the latter including basal cell carcinoma and squamous cell carcinoma. ³ Each of these arise from different cells in the skin, namely squamous cells, basal cells, and melanocytes. ³ Dr Piek says that NMSC greatly outnumber melanomas in incidence but fortunately, most are much easier to treat and are less deadly, as they tend to remain confined to their primary site and do not spread to the rest of the body. ³

Risk factors for skin cancer in people of colour

Dr Piek states that exposure to UV radiation that influences the function and survival of many cell types is regarded as the main causative factor in the induction of skin cancer: ³ “Ionising radiation, pollutants, chemicals and occupational exposures are also linked with skin cancers.” ³

Squamous cell carcinoma: in people of colour, UV light is not the primary risk factor, but instead factors that produce scarring and chronic irritation to the skin such as nonhealing ulcers, trauma (e.g. burns) and radiation are some of the greatest risk factors ^2,3

Basal cell carcinoma: the most significant risk factor is UV exposure but other risk factors include albinism, scars, sunburn, radiation therapy, HIV infection and immunosuppression ²

Malignant melanoma: the primary risk factor for melanoma in people of colour is undetermined and under diagnosed but other risk factors include albinism, burn scars, radiation therapy, trauma, immunosuppression (e.g. HIV) and pre-existing moles. ³

Dr Piek also emphasizes the importance of prevention, stating, "Prevention is better than cure - how to reduce your skin cancer risk." Here’s how to reduce your skin cancer risk ^2,3,5

• SHADE: Seek shade whenever possible, especially between the hours of 10 am and 4 pm.
• CLOTHING: Wear clothing that protects your skin from the sun - a wide-brimmed hat to shade your face and neck, shoes that cover the entire foot and sunglasses with UV absorbing lenses to protect your eyes.
• SUNSCREEN: Use a daily broad-spectrum sunscreen that is water resistant and that has an SPF of 30 or greater. Apply liberally to all areas of skin that are going to be exposed to the sun, 30 minutes before going outside, and then every 2 hours while outdoors (or after sweating or getting out of the water).
• AVOID: tanning beds, sunlamps, UV lamps (those used for acrylic nails). These emit harmful UV rays, which can cause skin cancer.
• SELF-EXAMINATION: Dermatologists recommend that ALL people, including those of colour, should preform a monthly full-body skin examination to detect early signs of skin cancer. Download the Self-examination for skin cancer prevention and early detection guide to learn about the ABCDEs of Melanoma.

About Life Oncology 

Life Oncology is a dedicated oncology and radiotherapy service under the Life Healthcare network. Our prime objective is to revolutionise the cancer treatment journey by embracing a patient-centric and value-based model, supporting our patients and their families throughout their treatment journeys. To support this journey, we ensure that our care is coordinated, integrated, and personalised.

Check the download section on the Life Oncology page here for more cancer educational information.

The information is shared on condition that readers will make their own determination, including seeking advice from a healthcare professional. E&OE. Life Healthcare Group Ltd does not accept any responsibility for any loss or damage suffered by the reader as a result of the information provided.

 

 

References:

1. Nelson B, Kaminsky DB. How Dermatology Is Failing Melanoma Patients With Skin of Color. Canc Cytopathol 2020:7-8. DOI: 10.1002/cncy.22229.
2. Davis DS, Robinson C, Callender VD. Skin cancer in women of color: Epidemiology, pathogenesis and clinical manifestations. Int J Women’s Dermatol 2021;7:127-134.
3. Gupta AK, Bharadway M, Mehrotra R. Skin Cancer Concerns in People of Color: Risk Factors and Prevention. Asian Pac J Canc Prev 2016;17(12):5257-5264.
4. American Academy of Dermatology Association (AAD). Skin Cancer in People of Color. [online] [cited 2022 Sep 13]. Available from: URL: https://www.aad.org/public/diseases/skin-cancer/types/common/melanoma/skin-color.
5. Shue-McGuffin KD, Powers K. Skin Cancer in People of Color: Misconceptions and Opportunities for Early Detection and Treatment. J Dermatol Nurses’ Assoc 2002;14(4):152-160.