Resource Library

Although anyone with skin is susceptible to skin cancer, certain genetic and lifestyle factors increase your risk. According to the American Cancer Society (ACS), the Centers for Disease Control (CDC), the American Academy of Dermatology (AAD), and the Skin Cancer Foundation, the major risk factors are:

• Fair skin. Light-skinned individuals are more than 20 times more likely than dark-skinned African-Americans to develop skin cancer. The reason is that dark-skinned people have more melanin (skin pigment), which filters out the sun's harmful ultraviolet (UV) radiation. People born with no skin pigment (albinos) are at a particularly high risk unless they take proper precautions to protect their skin.
• Male gender. Men are twice as likely as women to have basal cell carcinomas and three times as likely to have squamous cell carcinomas, according to the ACS. The disparity, says skin cancer specialist and AAD spokesman Brett Coldiron, M.D., is believed to stem entirely from lifestyle factors. That hypothesis is supported by the fact that women, who wear skirts and dresses, are more likely than men to get skin cancers on their legs, he says. Overall, though, men are at increased risk because they tend to have more outdoor occupations, "or at least they used to", says Coldiron, a clinical assistant professor of dermatology at the University of Cincinnati. "Until recently, there haven't been too many telephone lineswomen, and fewer women served in the military." Another probable reason, Coldiron says, is that women wear makeup, which contains a sunscreen or acts as one.
• Family history of skin cancer. If a blood relative has had skin cancer, you should consider your risk higher than average, do a skin self-exam monthly, stay out of direct sunlight, and avoid tanning parlors.
• Personal history of skin cancer. According to the ACS, 35 percent to 50 percent of patients diagnosed with one basal cell cancer will develop a new skin cancer within five years of the initial diagnosis.
• Chronic exposure to the sun. If you work outdoors, play outdoor sports, or otherwise spend lots of time outdoors, your skin cancer risk is increased.
• History of sunburns early in life. Instead of sunscreens, most baby boomers slathered on the baby oil and baked in the sun when they were young. If you sustained multiple blistering sunburns in your youth, consider yourself at high risk for skin cancer and show any suspicious skin changes to a dermatologist.
• Unusual moles. According to Coldiron, 99 percent of moles remain benign. But aa certain subset of moles, called dysplastic nevi, is not typical, often run in families, and occasionally become cancerous. Another cause of concern is congenital nevi, or moles that you are born with. "If they're bigger than a quarter, you should have them checked out because sometimes those can turn malignant," Coldiron says. "If they're bigger than your hand, then they're a real problem."
• A large number of moles.
• Freckles. Freckles form when pigment-producing cells clump together. While the freckles themselves rarely become cancerous, they are an indicator of sun sensitivity and sun damage.
• Living in a sunny climate.
• Outdoor enthusiasts. Skiers, hikers, and others who enjoy high-altitude outdoor activities are exposed to far more UV radiation than they would be exposed to at sea level, according to a study reported in the January 1999 Journal of the American Academy of Dermatology. Darrell S. Rigel, M.D., and colleagues from the New York University School of Medicine measured UV light energy in Vail, Colo., Orlando, FL., and New York City at solar noon in direct sunlight on cloudless days. Direct UV-B levels at 8500 feet in Vail were approximately 60 percent higher than at sea level in New York, researchers found. "In addition, the direct UV-B levels in Vail were the same as those in Orlando, a site nearly 775 miles closer to the equator," Rigel says. The intensity of the UV-B exposure suggests that a person having an average complexion, with unprotected skin, would burn after only six minutes of sun exposure on a clear day at noon in Vail at 11,000 feet above sea level. The same person would develop sunburn after 25 minutes of noontime exposure in New York or 14 minutes of unprotected noontime exposure in Orlando, according to the study.

Know your skin type

If you are unsure about your skin type, and thus your relative risk for skin cancer, the following list of classifications provided by the Skin Cancer Foundation should help. Type I has the highest risk; Type VI the lowest.

Type I is someone who always burns, never tans and is very fair, with red or blond hair and freckles.

Type II is someone who burns easily and tans minimally. This person is usually fair-skinned.

Type III is someone who sometimes burns and gradually tans.

Type IV is someone who has minimal burning and who always tans.

Type V is someone who very seldom burns, always tans and has medium-to-heavy pigmentation.

Type VI is someone who never burns, but tans darkly. This includes African-Americans as well as others with heavy pigmentation.

External Resources: American Cancer Society US Centers for Disease Control and Prevention Skin Cancer Foundation American Academy of Dermatology (AAD) Journal of the American Academy of Dermatology, January 1999 Interview with Brett Coldiron, MD, skin cancer specialist and AAD member (Nov. 1, 1999)

This article was published on 1999-11-05
This article was reviewed on 2003-02-03