Most skin cancers are caused by exposure to the sun; here are some tips to protect yourself

Centers for Disease Control and Prevention photo shows protection

By Melissa Patrick
Kentucky Health News

Tanning is not healthy. Despite the perception that a tanned person looks "healthy," tanned skin is actually damaged skin that has been exposed to ultraviolet rays. And it doesn't really matter if the exposure comes from the sun, or a tanning bed, or happens in the winter or the summer; UV exposure is the number-one cause of skin cancer in the United States, says WebMD.

In fact, skin cancer is the most common cancer in the U.S., according to the Centers for Disease Control and Prevention, with the American Academy of Dermatology estimating that one in five Americans will develop skin cancer in their lifetime.

“Repeated overexposure to the sun can lead to premature aging and skin cancers called basal cell carcinoma, squamous cell carcinoma and malignant melanoma, which is the deadliest form of skin cancer.” Dr. Tamar Zapolanski, a dermatologist at the Valley Medical Group in New Jersey, said in a news release.

The CDC notes that basal-cell and squamous-cell cancers, which affect the cells on the outer layer of the skin, are the most common kinds of skin cancer and usually respond well to treatment. Melanoma, the cancer that affects cells that give the skin its color, is much less common, but is more dangerous because it is more likely to spread to other parts of the body if not caught early.

In 2016, 3 percent of new cancers in the United states were melanomas, a rate that has been increasing steadily over the years, says the American Cancer Society, WebMD adds that melanoma causes 75 percent of all skin cancer deaths.

Kentucky Cancer Registry maps show occurrences of skin cancer (left) and deaths from melanoma, by county

In 2013, the most recent year with data available, the CDC reports that almost 72,000 Americans were diagnosed with melanoma, and more than 9,000 died from it. Between 2010 and 2014, 41 out of every 100,000 Kentuckian was diagnosed with a melanoma, and 33 Kentuckians out of every million died from it.

Anyone can get skin cancer, regardless of their skin color, but the risk is greatest for people with fair or freckled skin, light eyes and blond or red hair. Other risk factors include having a family history of skin cancer, having an outdoor job and living in a sunny climate. A history of severe sunburns early in life and having a large number of moles are also risks, says the CDC.

"Cumulative sun exposure causes mainly basal-cell and squamous-cell skin exposure, while episodes of severe sunburns, usually before age 18, can raise the risk of developing melanoma," says WebMD.

Not all skin cancers look the same. Experts say the most common warning sign of skin cancer is a change on the skin, like a new mole or skin lesion, or a change in an existing mole.

info-graphic: American Academy of Dermatology

They also recommend a simple rule to assess for melanoma, called the A-B-C-D-E rule:

• Asymmetry--Does the shape of one half match the other?
• Border--Are the edges of the mole irregular or jagged?
• Color--Does the color have uneven shades of brown, black, tan, red, white or blue?
• Diameter--Is the mole or spot larger than the size of a pea?
• Evolving--Has the mole or spot changed during the past weeks or months?

The CDC offers some tips to protect yourself from the sun:

• Stay in the shade, especially during the midday hours.
• Wear protective clothing on arms and legs.
• Wear a hat with a wide brim.
• Wear sunglasses that wrap around and have UVA and UVB protections.
• Use sunscreen with sun protection factor (SPF) of 15 or higher, and both UVA and UVB protection, even on cloudy days.
• Reapply sunscreen every two hours and after swimming, sweating or toweling off.
• Avoid indoor tanning.

“Sunscreen protects against harmful radiation from the sun by absorbing, reflecting or scattering the sun’s rays on the skin,” said Zapolanski, adding that skin cancer is very treatable if caught early.

Teens continue to use indoor tanning, in spite of risks; Ky. law lax

Kentucky teenagers are continuing to use indoor tanning in spite of the risks. Though tanning-bed use by children is illegal in 17 states and Washington, D.C., it is allowed in Kentucky. The Kentucky House passed a bill that would have made it illegal for those under 18 to use tanning beds, but it didn't pass the Senate. The law allows those under 14 to use tanning beds if accompanied by an adult, and those 14 to 18 can if they have a parental consent form.

Having a tan is a popular trend for those attending prom and other events like dances and graduation parties, Christine Fellingham writes for The Courier-Journal. "Usually, I go to a tanning bed before a dance," Naomi Popa, a 17-year-old Kentucky Country Day senior and occasional indoor tanner, told her. "I think it all started when one person went. Then everyone started going. If you're the only one who doesn't, you look so pale in comparison."

They continue tanning, even though doing so increases the risk of getting cancer. "Tanning-bed use can increase your risk of skin cancer by 59 percent," said Dr. Tamela Cassis, a Louisville dermatologist. In June the Food and Drug Administration sent a warning that minors shouldn't use tanning beds, and eventually all tanning beds will include a "black box" warning saying that those younger than 18 shouldn't use them, Fellingham notes.

Not everyone will pay attention. "We talk to parents and teens about the dangers of tanning all day long," Cassis said. "The youngest person I've treated to date for skin cancer was 16 years old. It required a wide local excision to cut it out. . . . It has made everyone in the family so much more aware. And like everyone else we see with skin cancer, he wishes he could take back the bad choices he made."

Young people face a lot of peer pressure to be tan because they often associate being tan with being attractive. According to a 2013 American Academy of Dermatology survey, 80 percent of people under 25 said they believe they look better with a tan. "I feel more confident with a tan," Popa said. "My skin clears up; I don't need as much makeup. I think I look better."

According to the academy, 2.3 million teens tan indoors every year, and 71 percent of those who use tanning salons are girls and women ages 16 to 29. In the past 40 years, skin cancer among females has increased eightfold, according to the Skin Cancer Foundation.  (Read more)

State House panel approves bills to require HPV vaccinations of boys and girls and ban use of tanning beds by children

The state House Health and Welfare Committee approved two bills Thursday to require that boys and girls to be vaccinated for the human papilloma virus before sixth grade and to generally ban use of tanning beds for those under 18. HPV causes cervical and oral cancer, and tanning is a cause of skin cancer.

House Bill 311 would allow parents to withhold consent for the HPV vaccination for any reason. House Bill 310 would bar anyone under 18 from using a tanning bed without a prescription. Under current law, use of a tanning bed by 14- to 17-year-olds requires consent of a parent or guardian.

Gov. Steve Beshear issued a press release praising the bills and the prime sponsor, Democratic Rep. David Watkins, a retired physician from Henderson. "Every year, more than 9,000 Kentuckians succumb to various forms of cancer, making the commonwealth the worst state in the nation for cancer-related deaths," Beshear said. "Last week, I outlined seven major goals to reduce our rate of cancer deaths, as well as improve Kentucky’s other dismal health statistics, by 2019. . . . I am optimistic that House members will look favorably upon these common sense measures to improve the health of Kentuckians and vote for their passage."

Slap on sunscreen, avoid UV rays this Memorial Day Weekend

This Friday has been designated "Don't Fry Day," a reminder to sun worshippers to be mindful of the dangers of skin cancer on Memorial Day weekend, the traditional start of the summer recreation season.

The National Council on Skin Cancer Prevention strongly urges the use of sunscreen if in the sun, but also recommends seeking shade, wearing sun-protective clothing and avoiding getting a suntan or sunburn altogether. It also recommends extra caution if near the water or sand. "While most everyone enjoys a sunny day, keeping your skin safe from overexposure to UV radiation can be easy by practicing simple sun-safety tips," said Dr. Sandra I. Read, Council co-chair.

The Council also recommends consulting the UV Index forecast, which assess the strength of solar UV radiation on a scale from 1 (low) to 11+ (extremely high).

Skin cancer is by far the most common type of cancer in the United States, research-reporting news service Newswise reports. More than 2 million new cases are diagnosed each year, more than new cases of breast, prostate, lung and colon cancers combined. Though the incidence of many common cancers is falling, the incidence of melanoma, which can be deadly, continues to rise. It is one of the most common cancers in young adults ages 15 to 29. (Read more)