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Blacks and skin cancer

Joseph Wright | 7/21/2010, 5 p.m.

Melanin is recognized as the chief element that protects the skin from the rays of the sun. Because Blacks have a greater abundance of this compound (although it varies within the African American population) than their lighter complected non-Black citizens, especially Whites, it is assumed by many that they are basically immune to skin cancer and other sun damage. This is especially true, when it comes to those who are dark-skinned. However, contrary to the widely-held belief, there are facts that Blacks must be aware of as the hotter summer temperatures approach.

People of all races and skin colors can get skin cancer. That is a fact that continues to surprise many people--Black and non-Black.

"Messages about prevention, diagnosis, and treatment often target Caucasians," said Dr. Cleophus Leonard, a West Los Angeles dermatologist. "However, African Americans and other non-Whites can develop all types of skin cancer."

As is the case with Whites, says dermatologist Dr. Deborah Longwill of Miami, melanoma is the third-most common skin cancer in Blacks, Latinos, and Asians. "Even though over 90 percent 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 percent over the last 15 years. That is basically the same as the annual rate of increase in Whites," Dr. Longwill said.

Among Black people, the incidence of melanoma is much lower due to the populations' greater production of the skin pigment melanin. "Generally, I would recommend protective clothing and sunblock for everyone," Longwill commented. "Although African Americans down here (in South Florida) are usually Type 6 (skin types in accordance to melanin density is one to six), that doesn't eliminate them from getting skin cancer. Dark skin is a great ally against the sun's rays, but all skin types can burn."

Some studies suggest that melanoma in African Americans is more likely to be genetic or job-related in origin rather than from the sun.

A study done in Champagne at the University of Illinois in the spring of last year, found a high rate of melanoma in African American women who worked in the machinery and transportation equipment manufacturing industries, where chemicals called polychlorinated biphenyls (PCBs) are commonly used. Other research has shown that risk factors such as pre-existing skin conditions, scars, and trauma play a larger role in skin cancer in people of African descent than ultra violet rays from the sun.

Melanoma is often missed in Blacks until later stages for many reasons. The lesions can look different or be harder to see on darker skin. Melanomas in African Americans is also more commonly developed on the palms, soles, toenails, fingernails, and in mucus membranes. This form of melanoma is called "acral."

In Whites and lighter-skinned Latinos, melanomas appear more frequently on the backs of men and on the legs of women, according to Dr. Leonard. "Studies show that Blacks are screened for skin cancer less than Whites," Leonard says. "The relative rarity of skin cancer in the non-White population simply fools some doctors into thinking a lesion is something else besides melanoma."

Many Blacks and other non-Whites perceive themselves as having low or no risk to skin cancer.

And that is not surprising, given the amount of prevention education that has been targeted at the White population.

Despite that practice and combined with the reality that people of color do have a lower risk of getting skin cancer, sun safe practices (e.g. sunscreens) and annual skin examinations should not be ignored.