Skin Cancer
Skin Cancer

Skin cancer is the most common of all cancers, afflicting more than five million Americans each year, a number that is increasing while other cancers are decreasing. 37% of Americans believe they are not at risk for skin cancer — in spite of industry statistics that report 1 in 5 Americans will develop skin cancer annually.

Basal cell carcinoma (BCC) is the most common type of cancer with an estimated 2.8 million people diagnosed annually. 8 out of 10 skin cancers are BCC which usually develop on sun exposed areas, especially the neck and head. Younger people are developing BCC more frequently due to increased time in the sun, though it used to be found mainly in middle-aged and older people.

The second most common form of skin cancer is Squamous cell carcinoma (SCC) which can be found in sun exposed areas such as face, ears, neck, lips, and backs of the hands. The incidence of SCC has been rising, with increases up to 200 percent over the past three decades in the US.

Between 40% and 50% of Americans who live to age 65 will have some form of skin cancer at least once.

The Melanoma Challenge

Melanoma is the deadliest form of skin cancer, and accounts for 75% of all skin cancer deaths, highlighting the mortality risk compared to other forms of skin cancer. It is a cancer of pigment-producing skin cells, known as melanocytes, and is generally caused by a combination of genetic risk factors and ultraviolet light exposure from the sun and tanning beds.

Every 57 minutes, one person in the U.S. dies of melanoma and 16 people are diagnosed with the disease, according to the American Cancer Society (ACS). An estimated 139,000 new cases of melanoma will be diagnosed in the US in 2014 and close to 10,000 deaths.

In the US, non-Hispanic white males are historically at the highest risk of melanoma, followed by non-Hispanic white females. Sun exposure, tanning bed exposure and light skin pigmentation may contribute significantly to the development of melanoma; however melanomas are possible on all types of skin and in areas of the body that typically do not receive sun exposure.

A National Cancer Institute report published in the July 10, 2008 online edition of the Journal of Investigative Dermatology indicates that the annual incidence of melanoma among young adult Caucasian women rose 50% between 1980 and 2004. Melanoma is the most common cancer in women aged 25 to 29 and the number-one cancer killer of women ages 30 to 35. Although no cure is currently available for advanced-stage melanoma, melanoma is virtually 100% curable if caught early.

Because early detection is critical to survival, the American Cancer Society recommends that all Americans over the age of 20 undergo complete skin examinations during their periodic health check-ups. The individuals in the US with dysplastic nevi, a type of pigmented skin lesion associated with an increased risk of melanoma, warrant more frequent observation.

Melanomas are mainly diagnosed by dermatologists using visual clinical evaluation. Dermatologists assess clinically atypical pigmented skin lesions using the “ABCDEPRU” criteria: Asymmetry, Border irregularity, Color variegation, Diameter greater than 6 mm, Evolving – a change in “ABCD” over time, Patient’s Concern, Regression, and Ugly Duckling. This assessment is subjective and results in missed melanomas as well as a highly variable ratio of benign lesions biopsied to melanomas detected; the biopsy ratio is as high as 50 to 1 for dermatologists. According to the American Cancer Society, there are roughly 5.5 million biopsies performed annually across all skin cancers, with 1.5 million biopsies performed specifically to diagnose melanoma. Of these biopsies, only 7% of tissue samples are positively identified as melanoma, meaning that 93% are of normal tissue.

Cost of Care

In the US, an estimated $2.36 billion is spent on care for melanoma with 65% of the being spent on continued care, 21% on the last year of life, and only 14% on initial care. If diagnosed early, a dermatologist removes melanoma at a cost of approximately $1,800 per patient. Treatment costs soar as the melanoma advances, rising to $170,000 per patient at the later stages and accounting for 90% of the overall melanoma treatment costs.

Healthy Lesion and Invasive Melanoma
See a side-by-side comparison of a healthy lesion and invasive melanoma from the skins surface and beneath the surface of the skin.
From Melanocyte to Melanoma
The epidemiology and etiology of Melanoma.
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