Is There A Skin Cancer Epidemic?
Over the past decades, the occurrence of skin cancer has gradually increased despite public awareness campaigns and prevention efforts. A recent study in the UK actually reported that there were more people dying from skin cancer than car accidents in some parts of the world. “It’s unsettling,” says Dr. Adam Mamelak, a board certified Dermatologist and Mohs Micrographic Surgeon in Austin, Texas. “There seems to be more and more myths about the the health benefits of sun exposure and the dangers of sunscreen.”
Dr. Mamelak treats patients with basal cell carcinoma, squamous cell carcinoma, melanoma and other skin malignancies at Sanova Dermatology and the Austin Mohs Surgery Center.
In 2014, the Surgeon General warned that an epidemic of skin cancers has developed over the last few years. The American Cancer Society agrees, noting that the instances of skin cancer diagnosed in the United States exceed those of breast, prostate, lung and colon cancer cases combined. According to the Skin Cancer Foundation, rates of skin cancer have been increasing during the past few decades:
- Treatment of non-melanoma skin cancers increased by nearly 77 percent between 1992 and 200.
- The incidence of squamous cell carcinoma has been rising, with increases up to 200 percent over the past three decades in the US.
- From 1973 to 2004 in young people age 15 to 39, melanoma incidence among males increased by 61 percent and incidence among females more than doubled.
The question arises, why is this happening? Several theories exist.
The last over the counter sunscreen product that has been approved by the FDA was in 1999. Eight applications have been filed for approval, but some have languished in the FDA bureaucracy for over a decade. Despite the fact that Congress has passed and President Obama has signed into law the Sunscreen Innovation Act meant to streamline the approval for sunscreen products, the FDA recently rejected all eight applications, citing the need, in its view, for more information. The lack of more effective sun protection is certainly a contributing factor to the instances of skin cancer. In the meantime, more and more people are proliferating the misconception that the sunscreens currently on the market are detrimental to one’s health.
Studies have shown that ~90% of skin cancers can now be directly attributable to ultraviolet light exposure. “It’s not so much that the sun has changed,” explains Dr. Mamelak, “it’s our attitude towards the sun that has changed so dramatically.” The popularity of tanning, for example, is a recent phenomenon, having developed over the last part of the 20th Century. The fashion of having tanned skin did not exist before the 1930s. The persistent popularity of indoor tanning also seems to be a contributing factor. Roughly 400,000 instances of skin cancer per year, including 6,000 melanomas, can be directly attributed to indoor tanning.
While most dermatologists agree that the skin cancer epidemic is real, with instances climbing every year, some specialists have suggested that the epidemic could be a result of over diagnosis of skin cancers. Since even the smallest lesion can turn malignant quickly and kill a patient, many doctors are not taking chances. However, the vast majority agree that over treatment is a minor contributor, if one at all, to the rising rates of these tumors.
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