SKIN CANCER FACTS

General Skin Cancer Facts:

  • Skin cancer is the most common form of cancer in the US.  More than 3.5 million skin cancers in over two million people are diagnosed annually.
  • Each year there are more new cases of skin cancer than the combined incidence of cancers including breast, prostate, lung and colon.
  • Over the past three decades, more people have had skin cancer than all other cancers combined.
  • One in five Americans will develop skin cancer in the course of a lifetime.
  • The annual cost of treating skin cancer in the US is estimated at $8.1 billion. Approximatly $4.8 billion for non melanoma skin cancer and $3.3 billion for melanoma.
  • Basal cell carcinoma is the most common form of skin cancer. Basal cell carcinomas are rarely fatal, but can be highly disfiguring if allowed to grow.
  • Squamous cell carcinoma is the second most common form of skin cancer.  The incidence of squamous cell has been rising, with increases up to 200 percent over the past three decades in the US.
  • Between 40 and 50 percent of Americans who live to age 65 will have either basal cell carcinoma or squamous cell carcinoma at least once.
  • Actinic keratosis is the most common pre cancer: it affects more than 58 million Americans.
  • Approximately 65 percent of all squamous cell carcinomas and 36 percent of basal cell carcinomas arise in lesions that were diagnosed as actinic keratosis.
  • About 90% of non melanoma skin cancers are associated with exposure to ultraviolet (UV) radiation from the sun.

 

Melanoma

  • One person dies of melanoma every hour (every 52 minutes)
  • An estimated 76,380 new cases of invasive melanoma will be diagnosed in the US in 2016 and approximately 10,130 will die from melanoma.
  • Melanoma accounts for less than 2 percent of skin cancer cases, but the vast majority of skin cancer deaths.
  • 1 in 50 men and women will be diagnosed with melanoma during their lifetime.
  • 25 percent of melanoma cases are found in people under the age of 45.
  • The incidence rate of melanoma has doubled since 1973.
  • Of the 7 most common cancers in the US melanoma is the only one whose incidence is increasing.
  • Melanoma is the most common form of cancer for young adults 25-29 years old and the second most common form of cancer for young people 15-29 years old.
  • Melanoma is one of only three cancers with an increasing mortality rate for men, along with liver cancer and esophageal cancer.
  • Survivors of melanoma are about nine times more likely than the general population to develop a new melanoma.
  • 86 percent of mutations found in melanoma are caused by ultraviolet radiation.
  • The overall 5 year survival rate for patients whose melanoma is detected early, is about 98 percent.  The survival rate drops to 62 percent when the disease reaches the lymph nodes, and 16 percent when the disease metastasizes to distant organs.

SKIN CANCER and ETHNICITY

Melanoma can strike men and women of all ages, all races and all skin types.

  • Melanocytes produce melanin
  • Melanin is the pigment in your skin that protects against skin cancer
  • More melanin = darker skin and decreased risk factor
  • Also raises the chance of late detection
all-races
survival-rates
skincancer_org

TYPES of MELANOMA

cases-chart
types-of-melanoma-superficial-spreading-melanoma

Superficial Spreading Melanoma

The most common type of melanoma, representing about 70% of all cases. This melanoma usually appears as a flat or barely raised lesion, often with irregular borders and variations in color. These melanoma lesions most commonly appear on the trunks of men, the legs of women, and the upper back of both sexes. These lesions are diagnosed most frequently in patients between the ages of 30 and 50. About half of these melanomas occur in pre-existing moles.1

How It Develops: Even though it may spread, it spreads along the top layer of skin, the epidermis, for a period of months to years before it goes deeper into the skin.

Signs: The darkening in one part of a pre-existing mole or the appearance of a new mole on unaffected, normal skin.

types-of-melanoma-nodular-melanoma

Nodular Melanoma

A melanoma that is found most often on the trunk, the head, or the neck, and represents 10% to 15% of all melanomas. Nodular melanoma is more common in men than women.

How It Develops: Unlike other melanomas that tend to grow across the surface of the skin (like an oil slick spreading), a nodular melanoma invades more deeply earlier and therefore often presents with a greater depth of invasion when it is found and biopsied. For this reason, nodular melanomas are more frequently associated with a poorer prognosis than other melanomas.

Signs: This melanoma usually appears as a blue-black, dome-shaped nodule, although 5% of the time the lesions are pink or red.

types-of-melanoma-lentigo-maligna-melanoma

Lentigo Maligna Melanoma

This melanoma comes from a preexisting lentigo, rather than a mole. Historically, only about 5% of all melanoma cases are lentigo maligna melanoma.

How It Develops: This type of melanoma typically takes many years to develop. It occurs most often in older adults, usually on the face and other chronically sun-exposed areas. Unlike nodular melanoma which has had a fairly stable rate of occurrence, the rate of lentigo maligna melanoma has been steadily increasing over the last decades. This increase is thought to be due to the fact that the development of lentigo maligna melanoma is more influenced by chronic sun exposure.2

Signs: These melanomas are generally large, flat, tan-colored lesions containing differing shades of brown, or as in other melanomas, black, blue, red, gray, or white.

types-of-melanoma-acral-lentiginous-melanoma

Acral Lentiginous Melanoma

“Acral” comes from the Greek word akron, meaning extremity, and the disease typically appears on the palms, soles, or under the nails. Less than 5% of all melanomas are acral lentiginous melanoma (subungual melanoma), but it is the most common melanoma in African-Americans and Asians.

How It Develops: Because of the misconceptions that melanomas only occur in sun-exposed areas and that dark-skinned and Asian people are not at risk for melanoma, these melanomas are often discovered later than other types.

Signs: These melanomas look like bruises or injuries to the palms, soles, or nail beds, which is why they are often not diagnosed early. When a melanoma occurs under the fingernail or toenail, it may present as a brown, black, or even a blue streak in the nail. In darkly pigmented individuals such as African Americans, it can be completely normal to have darker streaks under the nail because of the increased amount of melaninthat their normal melanocytes produce. However, in a Caucasian or similarly lightly pigmented person, dark streaks in the nail are very rare, and any streak that cannot be explained by a trauma must be seriously considered for a biopsy to prove that there is no cancer under the nail.

ocular

Ocular Melanoma

Ocular melanoma is melanoma found in the eye, and is relatively uncommon, accounting for only 3% of all melanoma cases. However, ocular melanoma is the most common type of primary intraocular cancer (tumor started in the eye) in adults. It begins when pigmented (colored) cells in the eye called melanocytes grow uncontrollably. Intraocular melanoma is also called uveal melanoma because it occurs in the part of the eye called the uvea.

References:

1. Skender-Kalnenas TM. J Am Acad Dermatol. 1995;33:1000-1007.
2. Forman SB. J Am Acad Dermatol. 2008;58(6):1013-1020.

OTHER TYPES of SKIN CANCER

other-skin-cancers-basal-cell-carcinoma

Basal Cell Carcinoma

What it is:

Most common type of skin cancer in fair-skinned people

More common than all other cancers combined

An estimated that 1 in 5 Americans will develop a basal cell carcinoma in their lifetime1

Associated with chronic sun exposure or sun tanning

Usually shows up on the face, ears, scalp, neck, or upper body

Signs:

Red patch

Pink, red, or white bump that is shiny or pearly

Crusty, open sore that will not heal

Scar-like area

Grows very slowly and usually does not spread to other parts of the body

Usually removed with surgery or by freezing the tumor

other-skin-cancers-squamous-cell-carcinoma

Squamous Cell Carcinoma

What it is:

Second-most-common type of skin cancer in fair-skinned people

An estimated 200,000 squamous cell carcinomas occur each year2

Twice as likely to occur in men as in women

Usually appears on the face, neck, arms, scalp, ear, lips, or mouth

Like other skin cancers, it is caused by excessive exposure to UV rays from the sun or indoor tanning booths

Signs:

Bump or scaly red patch

Slow-growing cancer

Can spread to other parts of the body; thus, it is important to treat it as early as possible through surgery or radiation therapy.

When on lips, it is associated with smoking or using chewing tobacco, and has a much higher rate of spreading to other parts of the body

References:

  1. 1. J Am Acad Dermatol. 1996;35:1012-1013;
    2. CA Cancer J Clin. 2008;58;71-96.
  2. Rogers HW, Weinstock MA, Feldman SR, Coldiron BM. Incidence estimate of nonmelanoma skin cancer (keratinocyte carcinomas) in the US population, 2012. JAMA Dermatol 2015; 151(10):1081-1086.
  3. Cancer Facts and Figures 2016. American Cancer Society.http://www.cancer.org/acs/groups/content/@research/documents/document/acspc-047079.pdf. Accessed March 17, 2016.
  4. Stern, RS. Prevalence of a history of skin cancer in 2007: results of an incidence-based model. Arch Dermatol 2010; 146(3):279-282.
  5. Robinson, JK. Sun exposure, sun protection, and vitamin D. JAMA 2005; 294:1541-43.
  6. UV Exposure and Sun Protective Practices. Cancer Trends Progress Report – March 2015 Update. National Cancer Institute.http://progressreport.cancer.gov/prevention/sun_protection. Accessed February 16, 2016.
  7. Karia PS, Han J, Schmults CD. Cutaneous squamous cell carcinoma: estimated incidence of disease, nodal metastasis, and deaths from disease in the United States, 2012. J Am Acad Dermatol 2013 June; 68(6):957-66.
  8. Lindelof B, Sigurgeirsson B, Gabel H, Stern RS. Incidence of skin cancer in 5356 patients following organ transplantation. Br J Dermatol 2000; 143(3):513-9.
  9. The Lewen Group, Inc. The burden of skin diseases 2005. The Society for Investigative Dermatology and The American Academy of Dermatology Association. 2005.
  10. Koh HK, Geller AC, Miller DR, Grossbart TA, Lew RA. Prevention and early detection strategies for melanoma and skin cancer: Current status. Arch Dermatol 1996; 132(4):436-442.
  11. Guy GP, Machlin SR, Ekwueme DU, Yabroff KR. Prevalence and costs of skin cancer treatment in the U.S., 2002-2006 and 2007-2011. Am J Prev Med 2014;104(4):e69-e74.  DOI: dx.doi.org/10.1016/j.amepre.2014.08.036.
  12. What are basal and squamous cell skin cancers? American Cancer Society.http://www.cancer.org/cancer/skincancer-basalandsquamouscell/detailedguide/skin-cancer-basal-and-squamous-cell-what-is-basal-and-squamous-cell. Accessed May 25, 2016.
  13. Bleyer A, O’Leary M, Barr R, Ries LAG (eds): Cancer epidemiology in older adolescents and young adults 15 to 29 years of age, including SEER incidence and survival: 1975-2000. Bethesda, MD: National Cancer Institute; 2006.
  14. 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.Brit J Dermatol 2001; 144:3:471-475.