April 26, 2001 (New York) -- The deadly skin cancer melanoma is three times more common among men aged 50 and older than in all other groups, a new finding that may partially explain the startling increase in rates of melanoma in the U.S.
Why? Well, that's a good question, says a panel of experts speaking here at a meeting sponsored by the American Academy of Dermatology (AAD).
The answer may be that the messages about the importance of using sunscreen are targeted mainly toward women, says Darrel Rigel, MD, a clinical professor of dermatology at New York University in New York City. Excessive exposure to the sun's UV rays is the most important cause of melanoma.
The new study looked at more than 240,000 people who were screened for skin cancer as part of the AAD's National Skin Cancer Screening program. Of these, 3,476 people were suspected to have melanoma, and tests later confirmed that 364 did have melanoma.
Nearly 60% of the confirmed melanoma cases were found in men, and 44% were men over 50, says study author Barbara Gilchrest, MD, professor and chair of the department of dermatology at Boston University School of Medicine.
"Middle-aged and older men are not detecting melanoma," she says. "It's startling for such a small population to have so many confirmed cases of melanoma. It's important that middle-aged and older men receive skin cancer education to help them detect melanoma in its early stage, when it is most curable."
Mark Minsky, a 50-year-old marketing researcher at Estee Lauder in New York, is one of the lucky ones.
"I am fortunate because my melanoma was found in its earlier stages," he says. His cancer was detected during a corporate screening program that, he confesses, he was very close to not attending.
During the screening, which took about 20 minutes, the screening dermatologist found five suspicious moles or spots on his body. Of those, two -- one on his leg and the other on his back -- were melanoma.
"Without the screening initiative I would never have known I had a problem," he says. Minsky had the cancer removed and has since become more vigilant and proactive about prevention.
"Melanoma is not a death sentence. It can be prevented, and if it's detected early, it's 95% curable," says Roger I. Ceilly, MD, a clinical professor of dermatology at the University of Iowa in Des Moines, and the chief of the dermatology section at Iowa Methodist Medical Center.
"Every year, more and more people develop skin cancer," he says.
By 2010, one in 50 Americans will get melanoma. "It's increasing faster than any other cancer in the U.S.," Rigel says.
More than one million new cases of skin cancer will be diagnosed in 2001, and 51,400 of them will be melanoma, Ceilly adds. "That's a 9% increase over 2000," he says. Middle-aged men are the main reason for this increase.
Part of the increase may be due to the ease in which people can travel from less sunny environments like New York City to high sun areas like Puerto Rico.
So what's a person to do? Start by following the lead of a group of skiers from Colorado and apply sunscreen frequently while outside, Rigel says.
In a study of 105 skiers in Vail, Colo., Rigel and colleagues found that SPF 15 and SPF 30 sunscreens offered the same protection against sunburn.
What made a difference, however, was how frequently the sunscreen was applied. Just 2% of skiers who applied their sunscreen every two hours or more frequently got a sunburn. By comparison, 10% of skiers who applied their sunscreen every 2.5 hours or less frequently got burned.
"The risk of sunburn is most influenced by lack of regular re-application," Rigel says.
His advice is to apply sunscreen 15-20 minutes prior to sun exposure to give it a chance to kick in, and then re-apply it every two hours, or even more frequently.
Remember, Rigel says, it takes 1 oz of sunscreen (a shot glass) to cover the entire body.
Other tips to prevent melanoma and other skin cancers include avoiding sun exposure during the peak sunlight hours of 10 a.m. to 4 p.m. and wearing protective clothing -- a wide-brimmed hat, sunglasses, long sleeves, and pants.
When doing self-skin exams, the experts recommend the "ABCD" rule for moles.
- A is for asymmetry. In healthy moles, one half of the mole will match the other half.
- B is for border. The border of moles should not be irregular.
- C is for color. Suspicious moles may have more than one color, such as black, tan, or brown and sometimes red, white, or blue.
- D is for diameter. A mole should be no larger than six millimeters, which is roughly the size of a pencil eraser.
If any moles demonstrate "ABCD," you should see your doctor immediately.