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Higher natural protection is not the same as immunity, when skin cancers deserve protection and action on skin of all colours.
Lead editorial appeared in the British Journal of Dermatology (BJD) in November 2021, reminding us where we are on equality. An esteemed publication, with a 130 year history, accepted that the balance was not as we would wish.
They quoted a study, where 47% of dermatologists felt their training was inadequate to diagnose disease in skin of colour. The representation of race across a range of clinical trials was found to be just 11%.
The latter could be seen as unfair, with ethnicity not the core point in most research but the issue does persist. In articles on skin conditions related to Covid-19, which are by nature recent, almost all images featured patients with light skin.
Similar tends to apply to skin cancer, with a look through medical books, or an internet search rarely finding images of darker skin.
Proposed Solutions
The BJD made three proposals, improving study resources, equality in editorial input and wider content focused on diversity. Publications are becoming available, online facilities have started to highlight dermatological conditions in darker skin.
All progress is welcome and will make a difference over time but the need is more urgent. Skin cancer is not just a fair skin disease, with over 10,000 cases a year reported on darker skin in the UK alone.
With the additional melanin dark skin possesses, easy to feel protection is absolute but this is not the case. Cases can still occur on any part of the body and areas such as the soles of feet, or beneath fingernails are particularly vulnerable.
The survival rate from serious skin cancers is equally concerning, with a 40% drop for patients with dark skin. Whilst longer term improvement matters, we must all take steps to lessen the issue now.
Actions Required
Wrong diagnosis can be a problem, although the prime requirement is to increase early diagnosis. Melanoma is a good example, 5 year survival rates for stage 1 are almost 100%, by stage 4 this drops to 30%.
Annual skin checks and self checking are just as important for those of us with dark skin. Where an anomaly is found, seeing a specialist as soon as possible is vital, their knowledge on how skin cancers develop should apply to everyone’s skin.
Shielding yourself from the prime cause of skin cancer also matters to all of us. Good sunscreen, protective clothing and time management in the sun will protect from skin cancer, along with other conditions and premature ageing.
Above all, awareness is the key. Spread the word that skin cancer on dark skin may be rarer but is a reality, keep your family and friends safe.