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Skin Cancer on the Rise

Cases of Nonmelanoma Cancers Reach 3.7 Million in U.S.

By Charlene Laino
WebMD Health News

Reviewed by Laura J. Martin, MD

(Feb. 7, 2011) New Orleans -- The number of nonmelanoma skin cancers continues to rise, with an estimated 3.7 million cases in the U.S. in 2009.

That's the latest figure from researchers who last year reported that more than 2 million Americans were treated for 3.5 million nonmelanoma skin cancers -- mainly basal cell and squamous cell carcinomas -- in 2006.

Although these skin cancers can be easily treated if detected early, "the long-established culture of tanning is creating a huge public health problem," says Brett M. Coldiron, MD, clinical associate professor of dermatology at the University of Cincinnati.

"We need to admit there's an epidemic," he tells WebMD.

Nonmelanoma Skin Cancers Rose 1.6% in 2009

For both studies, Coldiron and colleagues used Medicare claims data to count the number of skin cancer removal procedures among Medicare recipients and extrapolated figures to the rest of the population.

Their earlier report, published last year in the Archives of Dermatology, showed skin cancer removals among Medicare patients increased on average 4% a year from 1992 to 2006.

The new findings, presented at the annual meeting of the American Academy of Dermatology (AAD), showed that procedures among Medicare patients increased an additional 2.4% from 2006 to 2007, 2.6% from 2007-2008, and an additional 1.6% in 2009.

For Many, Damage Is Done

What's worse, the numbers may continue to rise, says AAD President Ronald L. Moy, MD, professor of dermatology at the University of California Los Angeles David Geffen School of Medicine.

That's because there is often a lag time of 20 years or more between sun damage and manifestations of skin cancer, he tells WebMD.

"For many baby boomers, the damage has already been done," Coldiron says. "Think back to the days when people used to lather baby oil all over their skin."

"If we keep going like this, there will be a doubling of [nonmelanoma] skin cancers in the next 15 to 20 years," Coldiron says.

Most Accurate Figures to Date

"The cost of all these cases is tremendous," Coldiron says. Diagnosis and treatment of each cancer tops $2,000, bringing the total cost of the 3.7 million cases in 2009 to more than $8.6 billion.

The researchers say their work provides the most accurate figures on skin cancers to date.

"You can't treat a nonmelanoma skin cancer without a positive biopsy, and the number of procedures for nonmelanoma skin cancers is available. So the number of procedures is an excellent proxy for the actual number of cancers," Coldiron says.

Still, some cancers fully removed during biopsies may have been missed, and some cancers that required multiple treatments may have been counted more than once, he says.

Coldiron notes that nonmelanoma skin cancer is a non-reported disease, and there are no available databases from national private insurers.

Tips for Minimizing Skin Cancer Risk

Studies show that "even though people know that overexposure to ultraviolet light can lead to skin cancer, they still tan. We need young people to realize that tanning for cosmetic reasons now will ultimately increase their risk for skin cancer," Coldiron says.

The AAD offers these tips to minimize your risk of skin cancer:

  • Always apply a broad-spectrum water-resistant sunscreen with a sun protection factor (SPF) of at least 30 to exposed skin when going outdoors.
  • Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses when possible.
  • Seek shade when appropriate, remembering that the sun's rays are strongest between 10 a.m. and 4 p.m. Rule of thumb: If your shadow is shorter than you are, seek shade.
  • Use extra caution near water, snow, and sand as they reflect the damaging rays of the sun, which can increase your chance of sunburn.
  • Avoid tanning beds. Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. If you want to look like you've been in the sun, consider using a UV-free self-tanning product, but continue to use sunscreen with it.
  • If you notice anything changing, growing, or bleeding on your skin, see a dermatologist. Skin cancer is very treatable when caught early.

Some of these findings were presented at a medical conference and should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

SOURCES: 69th Annual Meeting of the American Academy of Dermatology, New Orleans, Feb 4-8, 2011.Brett M. Coldiron, MD, clinical associate professor of dermatology, University of Cincinnati.Ronald L. Moy, MD, professor of dermatology, University of California Los Angeles David Geffen School of Medicine.Coldiron, B. Archives of Dermatology, March 2010; vol 146: pp 283-287.

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