From Axios this morning:
I always thought it was odd that in my grandparents generation, where they got a ton of sun exposure from working outside as farmers, there seemed to be only rare cases of melanoma. But apparently it’s severe sunburns when you were young that increase risk rather than sustained occupational exposure over time, at least according to the National Cancer Institute:
www.cancer.gov
Although melanoma accounts for only about 1% of skin cancers, it's responsible for the large majority of skin cancer deaths, according to the American Cancer Society (ACS).
Zoom in: Despite our relentless sun, Texas has the second-lowest melanoma rate in the country.
- The American Cancer Society found that Texas had a rate of 14.1 new cases per 100,000 people each year between 2016 and 2020. Only Washington, D.C., ranks lower.
- States like Vermont, Minnesota and Utah tend to see higher rates of skin cancer. Experts say that's because those states have a higher population of fair-skinned people, who are at a higher risk of developing skin cancer.
I always thought it was odd that in my grandparents generation, where they got a ton of sun exposure from working outside as farmers, there seemed to be only rare cases of melanoma. But apparently it’s severe sunburns when you were young that increase risk rather than sustained occupational exposure over time, at least according to the National Cancer Institute:
Factors Associated With an Increased Risk of Melanoma
UV radiation exposure
The relationship between UV radiation exposure and cutaneous melanoma is less clear than the relationship between UV exposure and keratinocyte carcinoma. In the case of melanoma, it seems that intermittent acute sun exposure leading to sunburn is more important than cumulative sun exposure;[9] such exposures during childhood or adolescence may be particularly important.[1]
Multiple case control studies have also documented the association between sun exposure and melanoma. Total sun exposure in childhood is associated with an increased risk for melanoma (odds ratio, 1.81–4.4) as is recreational sun exposure during childhood and adulthood, while occupational sun exposure may be associated with a decreased risk for melanoma.[10,11] Fair skin that sunburns easily has a twofold risk of melanoma compared with skin phenotypes that never burn. Natural red and blond hair and natural blond hair also confers a twofold to fourfold increased risk of melanoma.[12]
References
1. Koh HK: Cutaneous melanoma. N Engl J Med 325 (3): 171-82, 1991. [PUBMED Abstract]
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9. Gandini S, Sera F, Cattaruzza MS, et al.: Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure. Eur J Cancer 41 (1): 45-60, 2005. [PUBMED Abstract]
10. Lin JS, Eder M, Weinmann S, et al.: Behavioral Counseling to Prevent Skin Cancer: Systematic Evidence Review to Update the 2003 U.S. Preventive Services Task Force Recommendation. Agency for Healthcare Research and Quality, 2011. Report No.: 11-05152-EF-1. Also available online. Last accessed April 25, 2024.
11. Henrikson NB, Morrison CC, Blasi PR, et al.: Behavioral Counseling for Skin Cancer Prevention: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 319 (11): 1143-1157, 2018. [PUBMED Abstract]
12. Gandini S, Sera F, Cattaruzza MS, et al.: Meta-analysis of risk factors for cutaneous melanoma: III. Family history, actinic damage and phenotypic factors. Eur J Cancer 41 (14): 2040-59, 2005. [PUBMED Abstract]
Skin Cancer Prevention (PDQ®)
Skin cancer prevention strategies include avoiding risk factors such as ultraviolet radiation, and increasing protective factors. Get detailed information about factors that influence the risk of skin cancer and interventions aimed at preventing it in this summary for clinicians.
