Study shows patients with skin of color less likely to survive melanoma

Because Caucasians have a higher skin cancer risk than the general population, people with skin of color may believe that they don't need to be concerned about this disease — but new research reveals this to be a dangerous misconception.

According to a study published online in the Journal of the American Academy of Dermatology on July 28, although melanoma incidence is higher in Caucasians, patients with skin of color are less likely to survive the disease.

"Everyone is at risk for skin cancer, regardless of race," says board-certified dermatologist Jeremy S. Bordeaux, MD, MPH, FAAD, one of the study authors. "Patients with skin of color may believe they aren't at risk, but that is not the case — and when they do get skin cancer, it may be especially deadly."

Researchers at Case Western Reserve University in Cleveland utilized the National Cancer Institute's Surveillance, Epidemiology and End Results database to study nearly 97,000 patients diagnosed with melanoma, the deadliest form of skin cancer, from 1992 to 2009. Although Caucasian patients had the highest melanoma incidence rate, they also had the best overall survival rate, followed by Hispanic patients and patients in the Asian American/Native American/Pacific Islander group.

African-American patients had the worst overall survival rate, and they were also the group most likely to be diagnosed with melanoma in its later stages, when the disease is more difficult to treat. According to the study, however, the timing of the diagnosis is not the only factor that affects this group's survival rates, as African-American patients had the worst prognosis for every stage of melanoma.

Dr. Bordeaux says these differences in survival rates may be due to disparities in the timeliness of melanoma detection and treatment among different races; for example, patients with skin of color may not seek medical attention for irregular spots on their skin because they don't believe these lesions pose a risk. Additionally, he says, there may be biologic differences in melanoma among patients with skin of color, resulting in more aggressive disease in these patients. More research is necessary to determine why survival rates differ among different ethnic groups, he says, but in the meantime, patients of with skin of color should be aware of their skin cancer risk.

"Because skin cancer can affect anyone, everyone should be proactive about skin cancer prevention and detection," Dr. Bordeaux says. "Don't let this potentially deadly disease sneak up on you because you don't think it can happen to you."

Ultraviolet radiation exposure is the most preventable skin cancer risk factor, Dr. Bordeaux says, so everyone, regardless of skin color, should takes steps to protect themselves from the sun's harmful UV rays. The American Academy of Dermatology recommends seeking shade, wearing protective clothing, and using a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher.

Although sun protection is important for everyone, Dr. Bordeaux says, people with skin of color are prone to skin cancer in areas that aren't commonly exposed to the sun, including the palms of the hands and the soles of the feet. He says these individuals should be especially careful to examine hard-to-see areas when monitoring their skin for signs of skin cancer, asking a partner to help if necessary.

"Skin cancer is most treatable when detected early, so everyone should regularly examine their skin for new or suspicious spots," Dr. Bordeaux says. "If you notice any spots that are different from the others, or anything changing, itching or bleeding on your skin, make an appointment to see a board-certified dermatologist."