Men Over 50 Need Screening
Older adults have the greatest risk of developing melanoma, the deadliest form of skin cancer. Unfortunately, this fact hasn’t made a big impression on men.
A recent study reviewing the American Academy of Dermatology’s National Skin Cancer Screening Program shows that middle-aged and older men have the poorest track record for performing monthly skin self-examinations or regularly visiting a dermatologist. Thus, they are the least likely individuals to detect melanoma in its early stages, when it is almost always curable through surgical removal alone.
“This increases their chances of having an undetected melanoma spread, thereby requiring more radical treatment and lowering their odds of survival,” says study co-author Barbara Gilchrest, MD, professor and chair of the Department of Dermatology at Boston University. “That’s one reason why men over age 50 have a disproportionately high mortality rate from melanoma.”
Over 44 percent of the screened individuals diagnosed with melanoma were men over age 50, though this group comprised only 25 percent of those screened. Fortunately, the vast majority of their melanomas were not yet invasive or barely invasive. Without screening, many of these melanomas might have remained undetected until dangerously advanced. The study suggests that widespread screenings could vastly improve the cure rate.
At Any Age, Sunburn Raises Melanoma Risk; But Menopause May Provide Some Protection
You’re never too young or too old to be harmed by the sun. This may sound strange to you, because without the sun’s warming rays, life on earth could not exist. But the sun is both friend and foe. It is responsible for more than 90 percent of all skin cancers, which are now occurring at the epidemic rate of more than a million new cases a year in the United States. The sun can also age your skin before its time.
Skin cancer experts have long believed that sunburns suffered during youth are more likely to lead to melanoma, the deadliest form of skin cancer, than sunburns in adulthood. New research, however, suggests that sunburns at any age may be equally dangerous. This is true for both males and females, although one recent study suggests that women in their menopausal years may be less susceptible to melanoma.
Double Trouble. A team of scientists at the University of Erlangen-Nuremberg, Germany, recently found that having several sunburns over the course of a lifetime can double or triple melanoma risk, no matter when the sunburns occur.
The study included 603 melanoma patients and a control group of 627 individuals who had never had melanoma, according to lead researcher Annette Pfahlberg, PhD, assistant professor, School of Medicine, Department of Medical Informatics, Biometry & Epidemiology. All the subjects, from seven different countries in Europe, reported their history of sunburns, dividing them into two periods — before and after age 15. This dividing line proved irrelevant, because the patients’ risk of developing melanoma increased as their frequency of sunburns increased, regardless of when the sunburns occurred. More than five lifetime sunburns translated to twice the risk; more than 15 translated to three times the risk.
This is the largest case-control study (where patients who have a disease are compared against people who don’t) to investigate the different impact of childhood and adulthood sun exposure on melanoma development.
Temporary Exceptions. Women between 45 and 60 do appear to have some temporary protection against melanoma, according to another recent study that analyzed records from more than 100,000 melanoma cases nationwide. The researchers, at the University of California Irvine College of Medicine, believe that hormonal changes due to menopause may be the main reason that women’s melanoma risk decreases during these years. “This doesn’t mean that sun damage occurring during this age period necessarily has less of a long-range impact on women,” notes study leader Frederick Beddingfield, MD. “It just means that women’s risk of developing the disease may be lower during their menopausal years.”
Up until age 40, women are diagnosed with melanoma at a slightly higher rate than men. After 40, however, the rate increases dramatically for men while it levels off for women. Between ages 45 and 60, men are significantly more likely than women to be diagnosed with the disease.
Nonetheless, even sunburns occurring during menopause will take their toll, increasing women’s odds of developing melanoma after age 60, if not before. So, the skin damage caused by sunburn remains a significant concern for both males and females at all ages.
“Since it appears that sunburns throughout life contribute to melanoma, programs designed to educate the public about sun protection should not focus only on younger age groups or parents with young children,” says Dr. Pfahlberg. “Rather, they should be aimed at the entire population.”
The Skin Cancer Foundation recommends monthly self-examination and an annual screening by your physician.
