The basal cell carcinoma is the most common of all skin cancers,accounting for 80 percent of
non-melanoma skin cancers while the squamous cell carcinoma accounts for nearly 20 percent.
And,non-melanoma skin cancers are more common in men with squamous cell carcinoma affecting
2 to 3 times as many men as women while basal cell carcinoma occurs at a rate of 1 1/2 times of
men to women.
The American Cancer Society estimates that in 2019 an approximate 57,000 cases of
melanoma will be diagnosed in men and about 39,000 cases in women.And,the incidence of
melanoma is higher among men across most racial/ethnic populations.
Since most cases of skin cancer link to sun exposure ,it naturally follows that the
incidence increases with age.And,the incidence of melanoma increases after age 19 and peaks
for individuals older than 85. between 2011 and 2015 the median age for the diagnosis of melanoma
was 64.
In addition, the incidence of specific types of skin cancer varies according to race and
ethnicity.Consequently, the risk is more than 20 times higher for the white population than for people
with darker skin such as black,American Indian/Alaskan natives,Hispanic and Asian/pacific islander populations.
And,this is due to the photoprotection provided by increased melanin in the epidermis(outer skin layer)
of individuals with darker skin,which can filter twice as much UV radiation as the epidermis of white
individuals.
As is true for the white population,basal cell carcinoma is the most common skin cancer among
Hispanic and Asian populations . In contrast,squamous cell carcinoma is the most common skin cancer
in the black population and melanoma is the third most common skin cancer among all racial/ethnic
populations.
And, the highest rate of melanoma is found amiong white men and the lowest is among black
women. Although melanoma is predominate among white men compared to white women,the incidence
of melanoma in men and women is similar in black,Hispanic, and Asian/pacific islander population.
In addition to sun exposure and radiation exposure,the risk of skin cancer is also inluenced
by co-morbid or other conditions such as non-healing ulcers and tatoos as well as arsenic in the
well water . People whose immune systems are compromised either
by cancer or the drugs used to treat it are also at increased risk for skin cancer.
Also, skin cancer can develop in 30 to 70 % of organ transplant patients-with a 100 fold
increase for squamous cell carcinoma ,a 24 fold increase for a very dangerous type of skin cancer
called merkel cell carcinoma(please see my previous articles on merkel cell carcinoma),a six fold
increase for basal cell carcinoma and a two fold increased risk for melanoma.
Please see my previous article entitled: Skin Cancer-not just from the sun.
In addition, the prevalence of skin cancers is also high among individuals infected witrh
HIV (human immunodeficiency virus) and lesions in this population tend to be more aggressive.
Also, there is a high risk of squamous cell carcinoma associated with seropositivity for the
human papilloma virus (HPV) type 16 and 18 but a direct causal relationship has not been
established.
Individuals with a history of skin cancer are at increased risk for another skin cancer and
people living in areas where the sun's rays are most intense such as the equator have an
increased risk for melanoma skin cancer.
I saw a new patient in my office this week who came in for another problem but complied
with my request to take his shirt off when I promptly diagnosed a melanoma on his back.
A few years ago I diagnosedf 6 patients with melanomas in about 6 months.
In conclusion, if you see a change in the size,shape,color or behavior of spots on your
skin,get checked by your healthcare provider.
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