Lower Survival Rates
As is the case with Caucasians, melanoma is the third most common skin cancer in Hispanics, African-Americans, and Asians. For example, although more than 95% of melanomas are diagnosed in white and light-skinned people, the incidence of melanoma among Latinos has increased at an annual rate of 2.9% in the last 15 years, which is about the same as the 3% annual increase among whites. What's worse, they are more likely to be diagnosed at a later stage of the disease, which unfortunately results in a much lower survival rate.
Among African-Americans, the incidence of melanoma is even lower due to their greater production of the skin pigment called melanin. Indeed, the skin of African-Americans has been calculated to be the equivalent of a SPF 13 sunscreen. Some studies suggest that melanoma in African-Americans is more likely to be caused by genetics, or by job-related hazards, than the sun. One study found a high rate of melanoma among African-American women who worked in the machinery and transportation equipment manufacturing industries, where chemicals called polychlorinated biphenyls (PCBs) are commonly used. Other research shows that risk factors such as pre-existing skin conditions, scars, and trauma play a larger role in causing skin cancer than ultraviolet radiation from the sun.
Other types of skin cancer are also found in non-white populations. Basal cell carcinoma is the most common skin cancer among Hispanics and squamous cell carcinoma is the most common in African-Americans.
Diagnosis Is More Difficult
Melanoma in people of color is often missed until later stages for several reasons. First, the lesions can look different, or be harder to see, on darker skin. Second, melanomas in African-Americans and darker-skinned Hispanics and Asians develop more commonly on the palms, soles of the feet, toenails, fingernails and in mucus membranes such as around the mouth and genitals. In Caucasian and lighter-skinned Hispanics, melanomas more frequently appear on the back in men and on the legs in women. Third, studies show that both Hispanics and blacks are screened for skin cancer less frequently than are white non-Hispanics. Finally, the relative rarity of skin cancer in the non-white population simply fools some doctors into thinking a lesion is something else besides melanoma.
Prevention Is Still Important
Not surprisingly, darker-skinned individuals perceive themselves as having low or no risk for melanoma, as much of the public education efforts have targeted the white populations, especially those with blue eyes and blond or red hair. While it is true that their risk is much lower, sun safe practices (such as wearing sunscreen) and annual skin exams should still not be ignored. The fact is, nobody is immune to skin cancer.
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Gohara MA. "Skin cancer in skins of color." J Drugs Dermatol 2008 May;7(5):441-5. 31 May 2009.
Rouhani P, Hu S, Kirsner RS. "Melanoma in Hispanic and black Americans." Cancer Control. 2008 15(3):248-53. 31 May 2009.