SkinCancerNet Article
More Young Patients Hearing “You Have Skin Cancer”

While most cancers in the United States have been declining, the number of new skin cancer cases continues to grow. Each year, more than 1 million Americans learn that they have nonmelanoma skin cancer. Most cases of nonmelanoma skin cancer are basal cell carcinoma (BCC), followed by squamous cell carcinoma (SCC).

As years of unprotected sun exposure is a known cause of skin cancer and the risk of developing skin cancer increases with age, most diagnoses are made in people over 50 years of age. Across the United States, skin cancer rates continue to increase rapidly in this age group.

However, people over 50 may not be the only ones developing dramatically more skin cancers. A study published in the Journal of the American Medical Association reports that between 1976 and 2003, the incidence of nonmelanoma skin cancer in patients under 40 years of age increased significantly in Olmstead County, a county located in southeastern Minnesota.

This finding coincides with a trend that many dermatologists across the United States are seeing in their practices. More and more often, they are diagnosing patients who are in their 30s, 20s, and even teens with nonmelanoma skin cancer.

What’s causing this rise in skin cancer?
Researchers agree that advanced age combined with years of unprotected sun exposure is not causing the increase in skin cancer among people younger than 40. Findings from the Olmstead County study and other research suggest that the following may be contributing to the rise:

• Tanning bed use. Research shows that young women, who tend to use tanning beds much more frequently than young men, have an increased risk of developing nonmelanoma skin cancer with tanning bed use.
  
  Most tanning salons use bulbs in their tanning beds that emit a significant amount of ultraviolet A (UVA) and ultraviolet B (UVB) radiation. Ultraviolet (UV) rays are the primary cause of skin cancer. In fact, the United States Department of Health and Human Services lists UV radiation as a known carcinogen (cancer-causing agent). 
   

• More time spent tanning. Data shows that about 80% to 90% of diagnosed nonmelanoma skin cancers occur on the head and neck in adults. However, researchers in Minnesota found that the younger patients developed more BCCs on their torsos. Other studies also have found that younger patients tend to develop more nonmelanoma skin cancers on their torsos. This trend suggests that younger patients are spending more time outdoors tanning. Increased use of tanning beds also may be contributing to the rise in nonmelanoma skin cancers on patients’ torsos.
   

• Intense intermittent sun exposure. This is a known risk factor for melanoma. Now researchers suspect that short but intense exposure to the sun — such as seeking a tan during a tropical vacation or spending summer weekends outdoors without adequate sun protection — may be contributing to the increase in nonmelanoma skin cancer, especially in people younger than 40.

• Patient’s body may be less able to repair damage caused by exposure to ultraviolet (UV) rays. The sun’s rays and indoor tanning devices, such as tanning beds, emit UV light. While we do not feel or see this light when it hits our skin, exposure to UV light damages our DNA. The human body can repair this damage. However, with repeat exposure to UV light, the damage eventually outpaces repair. One research study suggests that young patients who are developing skin cancer may have less capacity to repair their damaged DNA.
   

• Smoking. Tobacco use is a known risk factor for SCC. Studies have found that cigarette and pipe smoking in particular increase one’s risk of developing SCC. The researchers in Minnesota also found this to be true. More than half of the patients who developed SCC were smokers or had smoked in the past.
  
  Other research studies have found that women between the ages of 20 and 40 who have developed BCC are more likely to smoke or to be former smokers.  However, the study conducted in Minnesota did not find this correlation.
   

• Ozone depletion. Earth’s atmosphere contains an ozone layer. This ozone layer helps shield the planet from the sun’s UVB rays. However, years of using aerosol sprays, refrigerants, and other products that contain chlorofluorocarbons has created a hole in the ozone layer. Each year this hole grows, and more UVB light reaches Earth. Exposure to UVB is known to cause nonmelanoma skin cancer as well as play a key role in the development of melanoma.
   

• Growing awareness of skin cancer. Researchers believe that the public’s increased awareness of skin cancer may be resulting in more diagnosis.

Skin Cancer Prevention
Regardless of your age, most skin cancer can be prevented by practicing sun protection. Research shows that sun protection also can help prevent skin cancer from recurring once a person has been diagnosed.

Sun exposure is the most preventable risk factor for all skin cancers, including melanoma.  You can have fun in the sun and decrease your risk of skin cancer.  Here's how to Be Sun Smart^SM.

If You Like the Look of a Tan
A survey conducted by the American Academy of Dermatology (Academy) in 2005 found that the majority (66%) of teens said they think people look better with a tan. A similar study conducted by the Academy found that 61% of women and 69% of men age 18 and older replied that they think people look better with a tan.

If you really want the look of a tan, dermatologists recommend using a self-tanning lotion. There are many fine products available today. When using a self-tanning lotion, it is important to remember that you also need to use sunscreen. Dermatologists recommend daily use of a broad-spectrum sunscreen with an SPF of 30 or higher when using a self-tanning lotion.

References:
American Academy of Dermatology. “New Survey Shows Teenagers Know Sun Exposure is Dangerous, Yet Most Still Want a Tan.” May 2, 2005. Last accessed February 15, 2006.

American Academy of Dermatology. “Dermatologists Encourage Consumers to be "Clothes" Minded When it Comes to Selecting Summer Wardrobe.” May 2, 2005. Last accessed February 15, 2006.

American Academy of Dermatology. “New Survey Finds Majority of Women Still Associate a Tan With Beauty and Health.” May 2, 2005. Last accessed February 15, 2006.

Christenson LJ et al. “Incidence of Basal Cell and Squamous Cell Carcinomas in a Population Younger than 40 Years.” Journal of the American Medical Association. 2005 August 10;294(6):681-90.

De Hertog SAE et al. “Relation Between Smoking and Skin Cancer.” Journal of Clinical Oncology. 2001 January; 19(1):231-38.

Saraiya M et al. “Interventions to Prevent Skin Cancer by Reducing Exposure to Ultraviolet Radiation.” American Journal of Preventive Medicine. 2004 December; 27(5):422-66.

All content solely developed by the American Academy of Dermatology