Gabriela Maloney, DO
Edited by Paul M. Graham, DO
May is Melanoma Awareness Month, and one of the common questions we hear from our patients is when should they start getting their moles checked. With the incidence of melanoma increasing every year, melanoma now represents 5.2% of newly diagnosed cancers in the USA, making it the 5th most common cancer in the country1. According to the National Cancer Institute, 2.2% of Americans will develop melanoma in their lifetime, resulting in 9,730 estimated number of deaths in 2017. Even though melanoma is an aggressive cancer, if diagnosed early it has an excellent prognosis, making skin checks an important component of skin cancer surveillance.
Melanoma is more common in patients with lightly pigmented skin, red hair color, tendency for sunburns, and family history of melanoma. Environmental risk factors include intense intermittent and/or chronic sun exposure, tanning bed use (especially under the age of 35 years), living near the equator, and immunosuppression. In addition, patients with more than 5 atypical looking moles are at a 4-6 fold increased risk of developing melanoma, and patients with more than 100moles on their body are at an 8-10 fold increased risk. Freckles and “sun spots”, also known as solar lentigos, also represent a risk factor independent of the number of moles present2.
It is important, however, to note that melanoma can also occur in darkly pigmented individuals. One specific type of melanoma called “acral lentiginous melanoma” occurs at a similar rate across all racial and ethnic groups. Acral lentiginous melanoma typically occurs in the palms and soles or underneath or around the nails2.
There is also a subtype of melanoma called “amelanotic melanoma”, which lacks the classic dark pigment that is classically seen with melanoma. Those lesions can be mistaken for other less dangerous types of skin cancer, or even mimic benign growths if not examined by a trained dermatologist.
Sunscreen is an important tool to prevent skin cancer, and regular use of effective sun protection (see SPF: What does it really mean?) has been shown to decrease the incidence of skin cancers, including melanoma3. However, everyday sun exposure can also cause the genetic mutations that lead to skin cancer2, so even those who wear sunscreen prior to prolonged sun exposure are still at risk.
Currently, there are no official recommendations on when one should start getting full body skin checks with a dermatologist, however, melanoma is one of the most common cancers in patients younger than 25 years of age and it can also occur in children4. In other words, it’s never too early to get your moles checked. If you, your children, or your loved ones have any of the risk factors for melanoma, have many moles on their body, or any lesions that you are worried about, go see a dermatologist for a skin examination today, as it could be life-saving!
- Cancer facts: melanoma of the skin. National cancer institute. https://www.cancer.gov/stat facts/html/melan.html, accessed on 05/06/17.
- Dermatology. Third edition. 2012;111:1885-1911.
- Green AC, et.al. Reduced melanoma after regular sunscreen use: randomized clinical trial follow-up. Journal of clinical oncology. 2011;29:257-63.
- Cancers in young adults. National Cancer Society. https://www.cancer.org/cancer/cancer-in-young-adults/cancers-in-young-adults.html accessed on 05/06/2017.
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