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Issues with skin cancer are much the same in the US as the UK, with similar advice given but have we taken note?
An old article recently led to a wide ranging skin cancer research paper from the year 2000. You could argue this is outdated but interesting to see how knowledge and views have changed over more than two decades.
There are clear positives, our improved understanding of rare skin cancers such as mucosal melanoma, or Merkel cell carcinoma. Although still too high, mortality rates from melanoma are notably lower.
Improved surgical techniques have helped, along with modern treatment for late stage cancers, including targeted therapies, immunotherapy and adoptive cell therapy. Early stage cases have also seen improved treatment.
21st century medical advances are welcome but other aspects researchers in 2000 hoped would take a positive path have not.
Skin Cancer Prevalence
The early paper was headlined “The incidence of skin cancer is increasing by epidemic proportions.”. A position which has worsened, with melanoma now the 5th most common cancer in the UK, generating around 17,000 cases a year.
Less serious but still significant basal cell and squamous cell carcinomas have also increased. Conversely, the age at incidence of skin cancer has reduced, what was at one time seen as a disease of age is often not.
Other factors remain similar, higher incidence and higher mortality rates in males. Harder to spot lesions to a degree, such as on the back but primarily, men are less likely to seek early medical support.
Societal Contributions
Apart from male reticence, we all need to look at how deeply the publicity on skin cancer dangers has penetrated. The messages from 20 years ago include:
1. “Early detection greatly improves the prognosis of patients.” – There has been a little improvement but resistance to acting on a visible skin problem and seeking specialist advice is still there.
They went on to say – “Patients who are educated about risk factors for skin cancer are more likely to self select for clinical screening”, along with highlighting “the advantages of an annual skin examination for all patients”.
Both points remain true and the level of warnings in the media, or at medical centres have increased but are not heeded by everyone they reach.
2. “An ability to identify potentially malignant lesions varies with physician training.” – This is changing slowly but lack of wide medical knowledge remains a factor, especially for less obvious cases.
A Need To Help Ourselves
Time has reinforced what was known some time ago. Not recognising and acting on new, or changing skin lesions can be self harming. Dedicated care is available, as are annual skin exams for lesions you might miss.
As a society, we have not wholly taken these messages on board. As an individual and as part of care for others, you can recognise their importance.
Another message from the old paper has not changed – “Sun exposure remains the most important risk factor for all skin neoplasms.” This is better understood, although not everyone acts accordingly.
A far more recent research paper in the BMJ demonstrated the need for protection. Whilst early detection remains of significant value, nothing reduces the incidence of skin cancer to the extent that daily sunscreen use does.
The tenets of two decades ago still hold true. Protect yourself from the sun, which may be pleasant but is not entirely your friend. Have your skin checked at least once a year and if in doubt at any time, see a dermatologist.
Skin cancer is a virulent disease if we allow it to be but in many cases, taking the right view makes this a manageable part of life.