Skin Cancer

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What is skin cancer?

Skin cancer is the most common type of cancer in New Mexico and in the US. The two most common kinds of skin cancer – basal cell carcinoma and squamous cell carcinoma – are highly curable. Melanoma is less common and more dangerous than the other kinds of skin cancer.

Basal cell and squamous cell carcinoma usually form on areas of the body that are exposed to the sun, including the head, face, neck, hands and arms. Blistering sunburns, particularly during childhood or adolescence, increase the risk for basal cell carcinoma and melanoma, while long-term (chronic) overexposure to UV radiation increases the risk for squamous cell carcinoma. In men, melanoma is often found on the trunk (the area between the shoulders and hips) or the head and neck. In women, melanoma often develops on the lower legs.

Keep in mind that skin cancer can occur on any skin surface, even on areas that don’t receive a lot of sun such as your palms, beneath your fingernails, between your toes or under your toenails and your genital area.

The risk of melanoma and other skin cancers can be reduced by limiting exposure to sunlight, which is the primary source of UV radiation.^{11. Saraiya, Mona, et al. Interventions to Prevent Skin Cancer by Reducing Exposure to Ultraviolet Radiation, A Systematic Review. American Journal of Preventive Medicine. 2004; 27(5) 422-466.}

Facts about skin cancer in New Mexico

About 320 new cases of melanoma skin cancer are diagnosed in New Mexico each year.
About 49 people in New Mexico die of melanoma every year. New Mexico had the fifth highest melanoma death rate nationally in 2006 — 26% higher than the national average.^{22. National Cancer Institute and Centers for Disease Control and Prevention. (2009). State Cancer Profiles. http://statecancerprofiles.cancer.gov/}
One third of people in New Mexico live in Albuquerque, which receives one of the highest levels of ultraviolet (UV) radiation in the nation.^{33. New Mexico Cancer Facts & Figures 2007: A Sourcebook for Planning and Implementing Programs for Cancer Prevention and Control (2007). Albuquerque, NM: New Mexico Department of Health.}
Rates of melanoma are rising in New Mexico. In 2006, the number of new cases of melanoma was more than two times higher than it was in 1975.^{44. National Cancer Institute and Centers for Disease Control and Prevention. (2009). State Cancer Profiles

U.S. county-level, U.S. state-level by gender, New Mexico county-level, and state-level historical trend incidence data queries. Incidence data based on data from the State’s Cancer Registry, the CDC's National Program of Cancer Registries Cancer Surveillance System (NPCR-CSS) November 2008/January 2009 data submission, and the SEER November 2008 submission. Retrieved October 30, 2009.}

Who is at risk of developing skin cancer?

Research has shown that people with certain risk factors are more likely than others to develop skin cancer. A risk factor is something that may increase the chance of developing a disease. Some personal risk factors are within a person’s control, such as using sun protection and being physically active, while others, such as the environment and genetics, are not.

Some people are at higher risk for skin cancer. Some common skin cancer risk factors to be aware of include:

Fair skin, light-colored eyes and blond or red hair.
A large number of moles, irregular moles or large moles.
Previous treatment for skin cancer.
A family history of skin cancer, especially melanoma.
Skin that burns in the sun and rarely tans.
Getting sporadic, intense exposure to the sun. For example, this might be someone who works indoors all week and then gets intense sun exposure on weekends.
Spending a lot of time outdoors.
Using tanning beds.

Sun protection during childhood is very important, because developing one blistering sunburn in childhood or adolescence more than doubles a person’s chances of developing melanoma later in life.^{55. Lew, R.A., Sober, A.J., Cook, N., Marvell, R. & Fitzpatrick, T.B. Sun exposure habits in patients with cutaneous melanoma: a case study. J Dermatol Surg Oncol, 1983; 12: 981-6.}

About 23 percent of lifetime exposure occurs by age 18.^{66. Godar, D.E., Urbach, F., Gasparro, F.P., van der Leun, J.C. UV Doses of Young Adults. Photochemistry and Photobiology, 2003; 77(4): 453-457.} However, sun protection across the lifespan should remain a priority. A person's risk for melanoma doubles if he or she has had five or more sunburns at any age.^{77. Pfahlberg, A., Kolmel, K.F., Gefeller, O. Timing of excessive ultraviolet radiation and melanoma: epidemiology does not support the existence of a critical period of high susceptibility to solar ultraviolet radiation-induced melanoma. British Journal of Dermatology, 2001; 144(3):471-475.}

To learn more about other skin cancer risk factors, visit the National Cancer Institute’s website.

For information on understanding your cancer risk, steps to reduce your risk and tools to manage your risk, visit Cancer Risk: Understanding the Puzzle.

What are the symptoms of skin cancer?

Skin cancer symptoms may vary from person to person. Be aware of changes that may be signs of skin cancer, such as:

Oddly shaped, colored or changing moles
Unusual white, reddish or brown patches that feel different than the skin around them (can be hard, scaly, rough or crusted)
Pinkish red or flesh-colored raised areas that feel unusual (hard, scaly, ulcerated or rough)
A sore that doesn’t heal

If you are concerned about a suspicious mole or lesion, the best thing to do is make an appointment with your doctor, who will evaluate your skin and make further recommendations.

Can I reduce my risk for skin cancer?

New Mexicans can protect themselves from the damaging effects of the sun:

Avoid exposure during the hours of most intense sunlight (10 am to 4 pm).
Wear a hat, long-sleeved shirt and pants when outside during peak hours.
Do not burn! Overexposure to the sun is the most preventable risk factor for skin cancer.
Wear sunscreen regularly with an SPF 15 or higher.
Avoid tanning beds.
Talk with a physician about your risks for skin cancer.

The Raising Awareness among Youth about Sun safety (RAYS) Project in the Comprehensive Cancer Program promotes sun safety knowledge and behaviors to New Mexico’s elementary-aged youth. Children in kindergarten through fifth grade are taught to be sun safe to reduce their risk for developing skin cancer.

What is ultraviolet (UV) radiation?

High levels of UV radiation are present during most days of the year in New Mexico. The UV Index predicts the strength of solar UV radiation on any given day using a scale from 1 (low) to 11+ (extremely high). You can use the UV Index to take appropriate sun-protective precautions and avoid overexposure to UV radiation. To learn the daily UV Index, visit the Environmental Protection Agency’s website.

What is cancer screening?

Screening is a test that is used to look for a disease before there are any symptoms. Cancer screening tests are effective when they can detect disease early. For some cancers, detecting disease early can lead to more effective treatment and better outcomes. In other cases, the risks associated with screening and treatment may be greater than the benefits. If you are concerned about skin cancer, talk with your doctor.

Screening tests are different from diagnostic tests. Diagnostic tests are used when a person has symptoms, and tests are intended to find out what is causing the symptoms.

What should I know about screening for skin cancer?

If you see changes like those described below, see your doctor. Skin changes are the most common warning sign of skin cancer. For information on what changes to look for, visit the National Cancer Institute website.

Use the ABCDE’s of skin cancer to help you look for changes:

Asymmetry – One half of the mole is different from the other. (If you draw a line through an asymmetrical mole, the two halves will not match.)

Border – Watch for moles that are uneven, blurred or lumpy around the edges.

Color – It’s normal for moles to be a solid brown color. A mole that turns a different shade of brown or black may be a sign of skin cancer.

Diameter – If a mole is growing, or is larger than the head of a pencil eraser, consult your doctor.

Evolving – Look for any change in size, shape, color or elevation over time.

When diagnosed early, most skin cancers can be cured. If skin cancer is suspected, a physician will remove all or part of the mole or lesion to check it for cancer cells.

Currently, there is not enough scientific evidence to recommend regular skin cancer screenings by primary care physicians for the adult general population.

Additional skin cancer resources

Citations

1. Saraiya, Mona, et al. Interventions to Prevent Skin Cancer by Reducing Exposure to Ultraviolet Radiation, A Systematic Review. American Journal of Preventive Medicine. 2004; 27(5) 422-466.

2. National Cancer Institute and Centers for Disease Control and Prevention. (2009). State Cancer Profiles. U.S. state-level and U.S. historical state-level mortality by age data queries. Mortality data based on the National Vital Statistics System public use data file. Retrieved April 15, 2010.

3. New Mexico Cancer Facts & Figures 2007: A Sourcebook for Planning and Implementing Programs for Cancer Prevention and Control (2007). Albuquerque, NM: New Mexico Department of Health.

4. National Cancer Institute and Centers for Disease Control and Prevention. (2009). State Cancer Profiles. U.S. county-level, U.S. state-level by gender, New Mexico county-level, and state-level historical trend incidence data queries. Incidence data based on data from the State’s Cancer Registry, the CDC's National Program of Cancer Registries Cancer Surveillance System (NPCR-CSS) November 2008/January 2009 data submission, and the SEER November 2008 submission. Retrieved October 30, 2009.

5. Lew, R.A., Sober, A.J., Cook, N., Marvell, R. & Fitzpatrick, T.B. Sun exposure habits in patients with cutaneous melanoma: a case study. J Dermatol Surg Oncol, 1983; 12: 981-6.

6. Godar, D.E., Urbach, F., Gasparro, F.P., van der Leun, J.C. UV Doses of Young Adults. Photochemistry and Photobiology, 2003; 77(4): 453-457.

7. Pfahlberg, A., Kolmel, K.F., Gefeller, O. Timing of excessive ultraviolet radiation and melanoma: epidemiology does not support the existence of a critical period of high susceptibility to solar ultraviolet radiation-induced melanoma. British Journal of Dermatology, 2001; 144(3):471-475.